About this role
This position has the responsibility of developing, implementing and maintaining an effective, ongoing,, data-driven clinical quality assessment and performance improvement program. The focus is on indicators related to improving clinical outcomes measured for patient/family care, and activities that impact patient health and safety.
- Responsible for ongoing review and oversight of clinical documentation ensuring quality of care and compliance with Conditions of Participation, state regulations/ licensing requirements and local coverage determinations.
- Assists with completing Quality Assurance and Performance Improvement (QAPI) activities which may including the 120-Day Report, Quarterly Record Review and QAPI initiatives for inpatient and home hospice settings in coordination.
- Oversees the timeliness and completeness of Plans of Care/ Treatment and assures that documentation and coding is consistent and supported across the record including visit notes, certificate of terminal illness, face to face, and referral.
- Monitors accuracy of ICD-10 coding, determination of terminal illness relatedness and choice of applicable comorbidities.
- Responsible for oversight of the quarterly medical record review, analysis of findings and identification of areas for improvement. Abstracts information and runs QAPI reports utilizing tools that measure and analyze compliance and reports findings to management.
- Responsible for Hospice Quality Reporting Program (HQRP) outcome data, utilizing findings for quality improvement efforts.
- Identifies, develops and monitors Performance Improvement Plans (PIP) based on outcome analysis, industry changes and agency opportunities/needs.
Qualifications
Qualifications
- A current license to practice as a Registered Nurse in the State of Connecticut
- Baccalaureate degree in nursing (Master's degree preferred).
- A minimum of ten years clinical experience in nursing, at least five years of which were in a hospice agency.
- Knowledge of quality assurance performance improvement activities
- Knowledge of Medicare Hospice COPs and State of Connecticut regulations