QUALITY MANAGEMENT ANALYST - HOME HEALTH

  • Full-Time
  • Albuquerque, NM
  • Presbyterian Healthcare Services
  • Posted 3 years ago – Accepting applications
Job Description
Overview:
Job Description
Type of Opportunity: Full Time
FTE: 1.000000
Exempt: Yes
Work Schedule: Days
Summary:
Responsible for Quality Assurance, Quality Improvement, OASIS/HIS Review, and Education Opportunities to ensure compliance with Federal and State regulations, Joint Commission Accreditation and Presbyterian Home Health and Hospice (PHH) policies and procedures.Responsibilities:
  • In conjunction with Director of PHH Quality and Medical Records, analyze, plan, develop, coordinate, implement and evaluates compliance with accreditation, regulatory and licensing requirements, policies, procedures and protocols, and recommends educational opportunities.

  • In conjunctions with Directors, Managers, and Supervisors, analyze, monitor, coordinate, or conduct audits and/or surveillance to assess sustained compliance with regulations, policies, procedures, and protocols to determine if documentation and practice meets current clinical standards of care. Document findings appropriately.

  • Research and stay up-to-date with current industry standards and regulations, and serve as a subject matter expert and staff resource for PHH. Collaborate with Operations to help ensure accurate and consistent service provision, charting and data entry to result in timely processing of claims that meet regulatory and licensing requirements, policies and procedures and protocol requirements.

  • Assist in evaluating, writing, and revising clinical and non-clinical policies/procedures for PHH.

  • Collaborate with Education Department, Directors, Managers and Supervisors to recommend and or conduct clinical education, competency and training elements for orientation and ongoing clinical staff.

  • Guide and assist Directors, Managers, Supervisors and Staff with utilization of Quality Assessment and Performance Improvement (QAPI) tools and processes. Develops materials and/or tools to assist staff with utilizing QAPI processes such as: audit tools, staff and/or patient educational newsletters or handouts, or training materials.

  • Participates on committees, councils, PHS initiatives, or projects. Perform root cause analysis and/or risk assessments of adverse clinical events and or compliant investigations, and serve as the PHH liaison for environment of care, emergency preparedness, and infection control oversight.

  • Track, trend and analyze data, and submit reports with recommendations to Directors, Managers, and Supervisors to help PHH achieve and maintain compliance with accreditation, regulatory and licensing requirements, policies, procedures and protocols, through incorporation of Outcome-based and Quality Improvement (OBQI) practices. Upon request, participates in reviews of the patients medical record and/or case conferences conducted by clinical teams, to present findings, and if necessary, offer recommendations for improvement. Coordinate mandatory regulatory reporting preparation, transmission and follow-up. Research and collaborate with staff to correct incomplete or incorrect data to finalize all required processing. Collaborate with Operations to help ensure accurate and timely processing of claims to meet regulatory requirements.

  • Provide coverage for Quality Management activities during absence of the Director of PHH Quality and Medical Records.
Qualifications:Education:Bachelors degree required
Requirements:
  • Minimum 3 years of experience in home health required.
  • Licensed RN, Physical Therapist, Occupational therapist or Speech Language Pathology required.
  • OASIS Certification required within 18 months of hire for Home Health.
Benefits:
Benefits
Benefits are effective day-one (for .45 FTE and above) and include:
  • Competitive salaries
  • Full medical, dental and vision insurance
  • Flexible spending accounts (FSAs)
  • Free wellness programs
  • Paid time off (PTO)
  • Retirement plans, including matching employer contributions
  • Continuing education and career development opportunities
  • Life insurance and short/long term disability programs

About Us
Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees. Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans.

We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.

About New Mexico
New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great.

Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC.

New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
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