Summary

The RN, Quality Improvement Specialist is responsible for ongoing assessment related to quality of care and clinical documentation across the Home & Supportive Care service line to include home health, hospice, palliative care, supportive care, remote patient monitoring, mobile health and other current or future programs and clinical areas as assigned.

The RN, Quality Improvement Specialist will advise administrative and clinical leaders on opportunities to drive improved outcomes and measures of success.

Essential Duties and Responsibilities

Quality Management and Performance Improvement Develop and maintain annual metric dashboards focused on industry standard Star Ratings. Complete regular updating and review of dashboard data, in addition to CMS reported data such as CASPER, QIES, and HCAHPS. Use the above referenced data to develop and implement a clinically focused and patient care directed annual QAPI plan and quarterly performance improvement initiatives, ensuring oversight and coordination of each PI initiative. Oversee the agency’s response to ADRs from all payers. Manage and coordinate the clinical review and timely submission of all HIS and OASIS files electronically as required by CMS. Create follow-up plans for staff that need remediation in accurate HIS or OASIS completion. Serve as the agency liaison with vendor responsible for Clinical Document Integrity (OASIS Scrubbing), including monitoring the data from the vendor and utilizing in performance improvement or educational initiatives for clinical staff. Address any documentation gaps required for accurate diagnosis coding, securing appropriate supporting documentation or physician input as needed. Develop the annual Home Health and Hospice Infection Control and Prevention plan, in consultation with CRH Infection Control Team. Update reports monthly and create action plans for improvement as needed.  Perform daily clinical record reviews for all new patient admissions ensuring all record components are complete. Perform routine clinical record reviews for active and discharged patients ensuring full regulatory compliance with multiple sampling of records reviewed each week. Address any errors revealed by clinical record review audits with appropriate action directly with clinicians or leadership. Support and/or oversee other quality, data management, or performance improvement tasks or initiatives as assigned by leadership. Demonstrate commitment to personal professional development by seeking educational opportunities and experiences to expand current knowledge base. Demonstrate a commitment to flexible work scheduling as necessary to meet the needs of the service line and varying shifts. Demonstrates a commitment to excellence in patient care and experience. 

Education and Experience

Minimum Required Education: An associate degree in nursing and obtain BSN within 2 years of hire.

Preferred Experience: Bachelor of Science in Nursing

Experience: 3 years inpatient, outpatient, or home-based nursing experience is preferred.

Certificates, Licenses, Registrations

Minimum Required:

Must hold, or be eligible for, and maintain licensure as a Registered Nurse (RN) in the Commonwealth of Virginia or compact state. Must hold, or obtain upon hire, and maintain current American Heart Association BLS Certification. Must hold and maintain a valid Driver’s License, automotive insurance, and acceptable Motor Vehicle Record in compliance with organizational policy and/or demonstrate a reliable method of transportation for work responsibilities.

Preferred: Certification in Nursing Professional Development, Certified Professional in Healthcare Quality (CPHQ) and/or clinical specialty related to service line.