TX & NM – Remote QC Manager, Hospice, ~Once Monthly Regional Travel
- Clinical License RN
- State(s) Compact, NM, TX
Position Summary: The Hospice Quality Assurance Manager is responsible for assisting the Compliance department in auditing the company’s electronic medical records system entries for compliance with all current federal, state, ACHC, and local standards, guideline and regulations and for assuring the highest degree of quality is adhered to in the care of clients.
- Obtain and maintain a working knowledge of state, federal, and ACHC survey procedures and interpretive guidelines as they apply to service provided by the agency
- Auditing of paper and electronic charts to ensure compliance with current federal, state, CHAP, and local standards, regulations and guidelines
- Confers with Director of Clinical Compliance and Education concerning quality compliance issues and participates on related committees.
- Conducts and coordinates routine audits of medical records to ensure accuracy in entries and works with appropriate leadership and team members to correct discrepancies.
- Coordinates auditing activities and projects ensuring confidentiality.
- Prepares various reports including audit summary reports for each branch.
- Developing, coordinating and participating in a multifaceted educational and training program that focuses on the elements of the clinical compliance program.
- Utilizes hospice clinical record audit tool for each patient review.
- Periodically assists in the revision of hospice clinical policies and procedures in light of changes in the needs of the organization and in the law, policies and procedures of government and private payer health systems.
- Seeks to ensure that all appropriate employees and management are knowledgeable of, and comply with, pertinent federal and state standards.
- Monitors external audit review processes.
- Maintains awareness of compliance issues
- Responds to administrative inquiries related to compliance issues or audits in conjunction with senior management
- Works with the education department to develop an appropriate effective training program for new employees and ongoing training for all employees
- Provides ongoing staff direction and support, ensuring that the electronic medical record is utilized in the correct manner and perform the needed corrections
- Assists with orientation for new employees, focusing on all overall understanding of the hospice philosophy, agency standards, program regulations and compliance, and correct clinical and administrative documentation
- Acts as a resource to hospice staff regarding standards, policies, regulations and provides in service training to leadership and staff as needed in these areas
- Prepare written and oral reports concerning audit outcomes, performance improvement projects and software related job duties
- Responsible for timely resolution of issues through communication and education of involved personnel
- Maintains a high degree of confidentiality at all times due to access to sensitive information
- Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
- Follows all Medicare, Medicaid, and HIPAA regulations and requirements
- Abides by all regulations, policies, procedures and standards
- Performs other duties as assigned
Position Requirements & Competencies:
- Registered nurse with current licensure to practice professional nursing in assigned states
- Graduate from an accredited registered nursing program
- Minimum two years’ experience; including one year in the area of hospice, home health, or public health nursing
- Supervisory experience is preferred
- Must possess knowledge of current hospice federal, state, and local standards, guidelines and regulations
- Demonstrated ability to motivate employees
- 2 years’ experience in administrative or quality assurance capacity preferred
- Must possess current CPR, First Aid Certification
- Must possess the ability to make independent decisions when circumstances warrant
- Must be knowledgeable of quality assessment and assurance procedures
- Strong communication skills and interpersonal skills
- Valid driver’s license and proof of insurance is required
- Overnight travel may be required
Addus provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.