What are the responsibilities and job description for the QAPI Compliance Specialist position at Partners in Home Care?
Job Summary:
The QAPI Compliance Specialist is responsible for maintaining Agency compliance with accreditation standards and implementing agency initiatives and professional growth opportunities to enhance clinical practice. This position uses expertise to support regulatory compliance and QAPI activities for Home Health, Hospice, Home Infusion, DME and HCBS programs and supports compliance and QAPI development initiatives and training for managers and staff. The goal of this position is to support clean agency practice to reduce risk and promote clean clinical delivery and claim capture. This position will review charts and audit for accuracy and completeness, ensure correction where appropriate, communicate professionally to applicable staff any findings needing corrective action, while supporting process development. This role can be Remote, in-office or Hybrid.
Essential Duties and Responsibilities:
1. Conducts quality improvement and compliance audits and performs other quality improvement activities as assigned by supervisor.
2. In coordination with Program Managers, facilitates quality improvement action plans and reports progress to the program Directors and Director of Quality and Compliance.
3. Provides oversight, planning and coordination of Quality management activities, including patient care reviews, compliance audits, concurrent and retrospective clinical record reviews. Trends and analyzes utilization, outcome and quality data.
4. Assembles records and data of audits for survey and accreditation requirements.
5. Assists with planning, organizing, and preparing competency education and annual skills fairs.
6. Partners with management to prepare for regulatory and accreditation surveys and oversees developing corrective action plans.
7. Coordinates internal investigations in response to reports of possible compliance violations. Assists in Additional Documentation Requests (ADRs) as assigned by supervisor and other regulatory audits.
8. Uploads OASIS & HIS data per CMS requirements as assigned by manager and downloads applicable reporting data.
9. Actively contributes to the development and revision of clinical policies and procedures, informed by data analysis, quality improvement initiatives, regulatory updates, and input from clinical program leadership.
- Maintains professional and effective communication with relevant staff to ensure audit findings are promptly communicated. Assists in developing processes to address and mitigate recurring audit trends.
10. Completes Quality related EMR workflow as assigned by supervisor.
11. Maintains confidentiality and adheres to all HIPPA guidelines and regulations.
12. Performs other duties as assigned by supervisor.
Qualifications:
- Preferred qualifications include clinical license: PTA, LPN, COTA; with current licensure in the State of Montana.
- 2 years of previous experience in the home care environment is ideal.
- Excellent computer skills and ability to self-learn software applications for presentation of educational material and for presentation/analysis of quality data.
- Ability to self-direct.
- Models’ appropriate behavior as exemplified by Mission, Vision, and Value statements of PIHC.
