**Job Type:** Regular **Time Type:** Full time **Work Shift:** Day (United States of America) **FLSA Status:** Exempt **When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.** **Job Description:** **What You’ll Do** : The Home Health Quality Improvement (QI) Manager is responsible for promoting practices and approaches to facilitate and support quality improvement efforts and compliance with regulatory requirements. The QI Manager will give guidance and direction to the QI team and vendors to ensure revenue capture and OASIS accuracy. The QI Manager will utilize evidence-based quality improvement principles to promote ongoing advancement in patient related outcomes. **More Specifically** : + Lead and manage the QI Coordinators and Coding Specialists. + Promote teamwork within the QI department to foster a working environment that promotes growth, a collaborative culture and consistency across branches. + Assist quality staff in finding solutions when process variations affect regulatory compliance or impede the revenue cycle. + Oversee the relationship with OASIS review vendor. Ensure timely processing of charts. Maintain outcome oversight and facilitate process change, as needed. + Monitor productivity and workload balance. + Understand Epic’s role in operations, identifying and coordinating requests for fixes and enhancements. + Collaborate with Clinical Management team to improve clinical-quality partnerships and team quality and outcome performance. + Facilitate review of random samples of clinical records to assure appropriate documentation. Reviews include verification of quality of care provided, appropriate visit frequency, appropriate follow up with physicians, adherence to the care plan, and appropriate documentation for reimbursement. Compile statistical data resulting from these reviews. + Work collaboratively with the Education Manager, or designee, regarding identified trends where opportunities exist such as regulatory adherence, clinical care, coordination of care, and documentation for the purposes of requiring education that is more extensive or action of clinical staff. + Work with the Director of Business Operations, or designee, to monitor payment denials and billing compliance held claims. Assesses the validity of these denials, and responds with additional information. + Work collaboratively with the Executive Director of Quality, Compliance and Education and the clinical leadership team to ensure ongoing compliance and readiness for DPH and other regulatory survey activities. **What You’ll Need** : + Bachelor's degree in Nursing from an accredited program or equivalent. + Registered Nurse (RN) with current valid license to practice nursing in Massachusetts and New Hampshire. Dual licensure is required. + COS-C certification required or obtained within 18 months of hire + CPHQ is desirable + 5 years recent experience in a home health and/ or hospice quality role + Management experience in a certified home health or hospice agency preferred + Expert knowledge of Medicare/Medicaid regulations in homecare and hospice + Knowledge of current health care trends affecting the home health and hospice industry. + Experience with Quality/Performance Improvement activities, including the use of QI tools such as PDCA **What You’ll Get** : + A highly competitive pay rate & benefits package, including generous PTO, 403(b), and tuition + A reasonable geographic territory with strong clinical support resources + A highly inclusive, diverse team that values the input of all staff to provide excellent patient care **As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.** **More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.** **Equal Opportunity** **Employer/Veterans/Disabled**