Eastern Connecticut Health Network - Vernon, CT
posted 4 days ago
About the position
The Quality Manager will work with the Administrator to coordinate department activities. Supports the department's efforts to audit, track and trend patient outcomes, analyzes data, develops and implements targeted programs and initiatives for improvement in areas identified such as correct coding and documentation initiatives, infection control program and records management. Quality Manager monitors all data for improvement in areas of need. Responsible to collect data for quarterly performance improvement initiatives, performs concurrent audits for compliance with state regulations and assists in progressive appeals in Medicare Claims appeals as well as documentation requests for determination of medical necessity. Quality Manager coordinates with Clinical Educator, for orientation, training, and development of Agency staff related to QAPI plan and initiatives. Quality manager supervises Clinical Documentation Specialists as well as Clinical Support Specialists.
Responsibilities
- Directly manages and supports the Quality Assurance program to meet Agency standards, licensure regulations and federal and state regulatory requirements.
- Manages all members of the quality department including two clinical documentation specialists and two clinical support specialists.
- Critical review and timely submission of quarterly process and outcome data for Quality Improvement.
- Critical review and timely submission of adverse events data for Quality Management.
- Works with clinical managers, program coordinators, clinicians, and others to compile and analyze performance improvement data from selected specialty areas.
- Performs concurrent review of records for various performance initiatives as part of agency QAPI program.
- Participates in Agency Orientation of all staff regarding the Quality Assurance and Performance Improvement Program.
- Assists in the management of payer and industry audits of claims and appeals process.
- Responsible for Agency's infection control program.
- Conducts quarterly infection control audits of patient records.
- Tracks and trends the results of the infection control program.
- Identifies both positive and negative trends in OASIS, documentation and care planning.
- Provides feedback to Clinical Educator and Clinical Managers to promote effective ongoing educational and staff mentoring.
- Serves on Agency committees as needed.
- Evaluation of staff performance per agency policy.
Requirements
- RN degree in Nursing from an NLN approved school or Registered Physical Therapist preferably with master's or doctorate degree.
- Possession of a current license to practice as a registered nurse or as a Physical Therapist, or Occupational Therapist in the state of Connecticut.
- Four (4) years full-time clinical nursing, Physical therapy, or Occupational therapy experience, at least two of which were in a home health agency.
- Knowledge of Community Health and Home Care Principles.
- Knowledge of Agency Policy and Procedures.
- In-depth knowledge of Medicare criteria.
- Excellent interpersonal relations skills, oral and written communication skills, and organizational skills.
- Possess adequate transportation to carry out job requirements.
Nice-to-haves
- Experience in Quality Assurance and Performance Improvement activities or other similar change implementation preferred.
- Knowledge of reimbursement criteria.
- Knowledge of and ability to apply and remain in compliance with accreditation and licensure regulations.
- Excellent negotiating skills and problem-solving skills.
Benefits
- Small territories and manageable caseloads for a better work-life balance.
- Flexible schedules to accommodate your needs.
- Front loaded paid vacation time with 26 days offered if you work 40 hours a week, otherwise prorated.
- Tuition reimbursement to help you continue your education and career growth.
- Medical/Dental/Vision/Voluntary Benefits/STD and more.
- Free parking and discounts offered through Perk Spots at local retailers, restaurants, and child care centers.
