Home Health Quality Manager

POSITION SUMMARY: The Home Health Quality Manager is responsible for facilitating and assuring Home Health service provision is compliant with Medicare, Medicaid, and other licensure and contractual requirements throughout assigned states.

Schedule: Per Diem (24-32 hours a week)

ESSENTIAL DUTIES:

• Assist in developing, reviewing, revising and implementing standardized agency and state specific policies, procedures and work processes that comply with Medicare, State Medicaid and other regulatory/ contractual payer agreements
• Provide ongoing regulatory and quality improvement training, guidance, and development opportunities to staff who affect the delivery of care
• Assist in development of audit plan for assigned projects and manages audit plan execution
• Coordinate the collection and analysis of all data related to quality indicators and utilizes findings to drive improvements, mitigate risks, and to increase the level of patient care
• Perform on-site ( as needed) and electronic audits and medical record reviews to assess branch level compliance with applicable rules and regulations
• Provides written audit reports/updates to Director as required
• Assists in developing educational webinars
• Assists with maintaining and making revisions to the policy/procedural manual to ensure compliance with company and contractual requirements on a state and federal basis
• Drive operational compliance and quality outcomes
• Participate in QAPI meetings
• Report internal and external audit findings at all levels including local, regional and senior leadership
• Assist in readiness preparation, and/or directly support regulatory agency inspection and audit. Assist in coordination, monitoring, execution, and driving accountability for the responses to any findings
• Assist in facilitating investigation, reporting and resolution of critical incidents and complaints
• Monitor publicly reported quality outcomes, patient satisfaction results, PEPPER reports, and OASIS Optimization reports and other quality and compliance indicators
• Assist with preparing accurate and comprehensive ADR / Appeal packets for timely submission
• 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

PERFORMANCE RESPONSIBILITIES:

• Maintains positive internal and external customer service relationships
• Maintains open lines of communication
• Plans and organizes work effectively and ensures its completion
• Meets all productivity requirements
• Demonstrates team behavior and promotes a team-oriented environment
• Actively participates in continuous quality improvement
• Represents the organization professionally at all times

POSITION REQUIREMENTS & COMPETENCIES:

• Bachelor’s degree in nursing field preferred
• Five year’s recent experience in HH
• Audit experience preferred
• Experience with numerous EMRs preferred
• Some experience in a large, fast-paced, results-driven, multi-site organization preferred
• Proficiency in Microsoft Word, Excel, PowerPoint and Outlook required
• Position may work remotely
• Must be self-confident, thorough, and prompt in completing assignments and projects
• Passionate, energetic, tenacious and resolute, with a high sense of urgency and a strong drive to produce results
• Excellent oral and written communication skills
• Ability to multi-task under tight deadlines
• Strong communication skills and interpersonal skills

To apply via text, text 5468 to 334-518-4376

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