Quality Improvement Specialist

Quality Improvement Specialist

Responsible for review/extraction of patient care data related to the Hospice Quality Reporting Program (HQRP) entered into the electronic medical record to ensure accuracy and completeness of information prior to submission to Centers for Medicare and Medicaid Services (CMS). Responsible for coordinating the collection of various quality measure data, analyzing this data for comparison to standards, and identifying areas in need of improvement.

- Graduate of an accredited School of Nursing. RN or LPN licensed in the state of Florida.

- A minimum of 3 years of clinical experience in hospice or related field.

- Previous experience in quality improvement highly desirable. Good communication and organizational skills.

- Ability to work independently and collaboratively with multiple departments and customers.

- Ability to organize and analyze data and summarize key issues relating to quality care and improvement.

- Proficient in navigating electronic medical records, use of Excel, Adobe, Word.

- Knowledge of state, federal and other regulations required for compliance with governmental audits.

- Responsible for submitting patient care data within defined time frames for each of the CMS required elements, including but not limited to the Hospice Item Set (HIS) and/or the Hospice Outcomes and Patient Evaluation (HOPE) data.

- Responsible for review of HIS/HOPE validation reports to verify acceptance or rejection of records/monitor for any warnings or fatal errors.

- Responsible for identifying any inaccuracies in a submitted record, and taking steps to correct in the CMS system.

- Responsible for remaining current with any updates/revisions by CMS to the HIS/HOPE/HQRP processes.

- Identifies deficits related to HQRP data review, and create appropriate education/feedback on the team and/or individual level.

- Responsible for obtaining and reviewing monthly and quarterly HQRP reports in the CMS database to monitor for organizational performance and reporting to quality manager/senior leadership.

- Assists with the implementation of the Quality Assessment Performance Improvement program.

- Assists in the development of valid criteria for audits.

- Compiles reports and statistics obtained from audits and provides them to the quality manager.

Other requirements and specifications:

Supervision required: Direction/guidance is obtained from Quality manager and Director of Quality as needed. Working relationships with other departments are maintained for the purpose of sharing knowledge, resources, and ideas.

Contacts: Contact is made with internal/external customers daily or as needed.

Working conditions: Indoor office environment with offsite visits as needed. Day shift, but may require some after hours on occasion.