RN Quality Assurance Process Improvement Specialist

Newport News, Virginia

Hiring Range

$38.60 - $53.08/Hourly Actual pay is determined based on job-related factors such as relevant experience, education, credentials, skills, internal equity, and business needs.
Overview
The Home Health Quality Assurance and Performance Improvement (QAPI) Specialist, works under the direction of the Home Health Quality Manager, and promotes compliance with all operational processes that impact agency outcomes including clinical, quality, and revenue cycle management in alignment with regulations by reviewing and reporting on findings to program leaders in order to mitigate risk and maintain high-quality services. Monitors regulations that impact Home Health. Subject matter expert for OASIS and documentation integrity and throughout for home health service line. Performs audits on documentation to validate the accuracy of OASIS Data, plan of care content, skilled need, face-to-face regulations, compliance with CoPs, and re-certification. Manages workflow within the EMR system. Communicates regularly with the multi-disciplinary team regarding audit outcomes and will provide mentor-ship to drive changes. Understands and applies quality standards to all aspects of the documentation integrity program. Provides support and expertise for creating compliance focused action plans. Participates in the accreditation processes for the agency and supports a state of readiness.

What you will do

• Ensures OASIS and other clinical documentation is complete, thorough, accurate and demonstrates documentation integrity that is aligned with state and federal regulations. Updates guidelines for OASIS and other programs and relays this information to staff.
• Ensures that company- wide & agency specific quality assurance and control processes, and activities, are in place and being maintained. Conducts Clinical Record Reviews and completes required reporting tools within designated time frames.
• Participates in the development of and conducts follow-up audits as a result of internal review findings. Evaluates clinical documentation to ensure professional standards of practice, regulatory compliance, and reimbursement standards are met. Identifies areas for improvement/training. Participates in maintaining survey and accreditation preparedness, including the performance of mock surveys.
• Serves as a resource to employees. Provides support to staff and leadership regarding patient care, OASIS completion, clinical documentation, and regulatory compliance requirements. Assists with additional staff training identified through quality/regulatory compliance activities as recommended by management team. Travel to home settings or multiple agencies is required to complete these duties.

Qualifications

Education

• Associates Degree, Professional Nursing (Required) or
• Program Graduate, Diploma Nurse Program (Required)
• Bachelors Degree, Nursing (Preferred)

Experience

• 1 year Quality Assurance experience (Preferred)
• 2 years Homecare Nursing experience (Preferred)

Licenses and Certifications

• Registered Nurse (RN) - Virginia Department of Health Professions (VDHP) or licensed in a compact state Upon Hire(Required)
• CPR/BLS Certification - American Heart Association/American Red Cross/American Safety and Health Institute (AHA/ARC) within 30 Days(Required)
• Drives personal vehicle for RHS business 25% or more of the time to perform essential functions of the job
• Valid Drivers License Required

Other Requirements

• Work/Float in more than one work location

To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.