Quality Improvement Coordinator (RN)

Horizon PACE is excited to announce an amazing opportunity to be part of Horizon PACE’s program (Program of All-Inclusive Care for the Elderly). This innovative program is for individuals 55 years or older, who are living with chronic illness, or disabilities and need coordinated medical care to continue living as independently as possible in their home and community. The healthcare team at Horizon PACE will approach coordinating medical, social, and home care services so individuals no longer need to manage their medical care alone. Horizon has over 25 years’ experience providing care in Kentucky and is the largest provider of adult day health care services in the state. Horizon is opening 3 PACE locations in Kentucky, and we are excited to expand services to older Kentuckians. Horizon has an excellent benefit package including competitive pay, medical, dental, vision, life coverages, as well as generous paid time off, holidays, 401K, and many more.

Under the supervision of the Quality Improvement/Compliance Officer, develops, organizes and monitors a Quality Improvement and Performance Improvement Plan for Horizon PACE. The Quality Improvement Coordinator in conjunction with the Medical Director and Quality Improvement/Compliance Officer is responsible for developing the annual QI plan and guiding the implementation of the plan. Ensures that data is collected from all appropriate sources; and the data is examined, and the results are shared with all stakeholders. Oversees the process to evaluate and resolve medical and non-medical grievances by participants, their family members, or representatives. The Quality Improvement Compliance Officer acts as the Compliance and (HIPAA) Privacy Officer for their specific location. The Quality Improvement staff person is responsible for indirect oversight of the Medical Record Coordinator to ensure all CMS and State required activities related with these positions are accomplished. Works closely with the Corporate HIPAA Privacy Officer.

Position Responsibilities:

• Develops and guides the implementation of the annual QI plan. Collaborate with the Medical Director and Quality Improvement/Compliance Officer in development of the annual quality plan.
• Review, revise and communicate the quality plan to participants, staff, contractors, administration, participant advisory committee and the Board. Send the annual QI Plan to appropriate state and federal agencies.
• Strives to ensure staff integration into the QI process through Continuous Quality Improvement education and developing opportunities for input.
• Analyses of risk management data, and quality assessment performance improvement activities data with the objective of identifying and controlling loss to protect the assets of the organization.
• Has responsibility for the Medicare Part D fraud, waste and abuse Compliance Program for Horizon PACE at their specific location. Makes reasonable efforts to ensure completion of the activities and responsibilities identified in the Compliance program and those activities and responsibilities related to the HIPAA privacy rule and practices are in compliance with state agencies and CMS.
• Works closely with Medical Records Coordinator and indirectly oversees functions, assuring that all medical records documentation requirements are met, and that records and data of all types are maintained per Horizon PACE policies and procedures and are retained for the period of 10 years.
• Write/compile the Annual QI Report at the end of the fiscal (calendar) year, review it with the Medical Director and Executive Director, and share it with participants, staff, contractors, and administration, the participant advisory council and the Board. Send the annual QI Report to appropriate state and federal agencies.
• Develop, monitor, and report on PACE Health Plan Management System (HPMS) quality indicators. Prepare presentation of quality improvement for quarterly Quality Care Team.
• Oversees the process to evaluate, and resolve medical and non-medical grievances by participants, and or their representatives, ensures information is reviewed for incorporating issues in development of Quality improvement initiatives and annual QI plan.
• Attend quarterly participant advisory committee meetings and, staff meetings and report on QI.
• Integrate QI into orientation and training for new staff.
• Facilitate QI meetings to ensure that the developed plan is successfully installed and maintained.
• Assist senior staff and mid-level managers with establishing process evaluation and performance improvement initiatives Help staff identify problems and facilitate their problem resolution efforts.
• Acts as the Horizon PACE’s LLC’s Compliance and Privacy (HIPAA) Officer and provides initial training to new hires, and ongoing training to existing staff and contract organizations.
• Trains managers and supervisors in essential monitoring methods and measurement techniques specific to quality indicators.
• Facilitates quality assurance communication between contract facilities and Interdisciplinary Team and associates. Participates in orientation with contract facilities to help ensure effective coordination of participants’ care.
• Will review medical supply and medication inventory documentation monthly to ensure accuracy and compliance.
• Develop, implement and analyze quality studies and quality surveys.
• Coordinate internal audits and corrective action plans with required administrative staff.
• Stay abreast of new developments (e.g., HPMS, other), report to Executive Director/Quality Improvement/Compliance Officer and recommend changes in policies, procedures, forms as appropriate.
• Develop and implement a program of staff development and in-service training to meet regulatory requirements and organizational needs within available resources.
• Maintain documentation of staff development and in- service training in compliance with standards and regulatory requirements.
• Oversee compliance with all applicable regulatory, contractual standards.
• Develop schedules for required periodic compliance activities, monitor implementation, analyze and report on adherence.
• Recommend corrective action plans to Executive Director and oversee executive management team activities to implement approved corrective action plans.
• Manage preparations for site visits and inspections.
• In conjunction with the Executive Director and Quality Improvement/Compliance Officer, conducts annual satisfaction surveys of the participants and caregivers of Horizon PACE, LLC. and report findings.
• Manage ad hoc and special projects assigned by Executive Director.
• Participate as a fully contributing member of Horizon PACE, LLC’s management team, participating in meetings, contributing to strategic plan, supporting the decisions of the management team.
• Participate in formulation and maintenance of Horizon PACE, LLC’s policies and procedures.
• Perform other related duties as required.

Knowledge & Abilities:

• Supports the Mission, Values, and Vision of Horizon PACE and the facility and adheres to the Corporate Compliance Code of Conduct.
• Is knowledgeable of participant rights and ensures an atmosphere which allows for the privacy, dignity and well-being of all participants in a safe, secure environment.
• Supports, cooperates with and implements specific procedures and programs.
• Supports and participates in common teamwork.
• Assist supervisor with various tasks to support department operations as directed; may also be assigned special projects.
• Perform tasks which are supportive in nature to essential functions of the job, but which may be altered or re-designed depending on individual circumstances.
• Assists participants and caregivers in filing grievances.

Experience & Education:

• Graduate of a school of professional nursing program required. Current Kentucky Registered Nurse or Kentucky Licensed Practical Nurse License.
• Familiarity with operational, financial, quality assurance, information privacy laws, policies and regulations required.
• Minimum of 1 years working with the frail or elderly preferred.

Job Type: Full-time

Pay: $32.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Medical Specialty:

• Geriatrics

Physical Setting:

• Clinic

Supplemental Pay:

• Retention bonus

Ability to Commute:

• Richmond, KY 40475 (Required)

Ability to Relocate:

• Richmond, KY 40475: Relocate before starting work (Required)

Work Location: In person

Salary : $32