RN Quality Assurance Specialist

Salary: $75,000 - $85,000 per year depending on experience

Location: Hobbs, NM

Position Summary: Primary function is to oversee quality improvement program based on agency policies and procedures.

Essential Functions

• Conduct comprehensive clinical record reviews for clinical notes/charting, starts of care, resumptions, recertifications, and discharges for Home Health to ensure Home Health eligibility per CMS standards.
• Conduct comprehensive clinical record reviews for clinical notes/charting, starts of care, resumptions, recertifications, and discharges for Hospice to ensure Hospice eligibility per CMS standards.
• Ensure OASIS assessments accurately reflect patients’ current health status to improve outcomes, star ratings, VBP.
• Perform ongoing patient chart audits to identify and resolve documentation discrepancies and collaborate with the team to implement improvement.
• Collaborate with the team to develop ongoing educational programs that improve documentation quality and compliance.
• Maintain proficiency in CMS and industry best practices for OASIS standards, coding, PDGM.
• Development of QAPI quarterly reports and on-going Quality compliance program.
• Conduct remote mock surveys for all sites to ensure survey readiness for Home Health, Hospice and PCS.
• Responsible for conducting an ongoing comprehensive and integrated Agency assessment of the quality and appropriateness of the care provided, including services provided under arrangement
• Demonstrates an in-depth knowledge of, and ensures compliance with, all local, state, and federal laws relating to the operations of the Agency.

Other Related Functions

• Monitors and review all documentation submitted to clinical record for Home Health and Hospice for compliance.
• Responsible for staying up to date with ongoing CMS updates for Oasis, VBP, Outcomes, HIS and HOPE updates, Casper reports, Star Ratings.
• Multistate knowledge of federal and state regulations for Texas and New Mexico.
• Utilize BI tool and identify trends to improve overall clinical compliance.

Experience

• At least three (3) years of clinical nursing experience required (Home Health and Hospice preferred).
• Candidates must have at least three (3) years of QAPI experience in Home Health and Hospice.

Education/Training

• Graduate of an approved school of professional nursing, with current licensure in the practicing state(s).
• Proficiency in QAPI, documentation, time management, and organizational skills.
• Experience with Axxess software or similar software is highly preferred.
• OASIS certification and Oasis coding is highly desirable.
• Experience with quality compliance program, VBP, outcome measures, star ratings.
• Knowledge of Hospice HIS/HOPE measures for improvement.

Licensure/Certification

• TX and/or NM nursing license.