What are the responsibilities and job description for the Quality Improvement Specialist position at Visiting Nurse Association of Boston & Affiliates?
Position Summary: Responsible for the development, implementation and evaluation of overall quality and performance improvement plans, projects (PIPs) and initiatives at VNA Care. Works collaboratively with the Quality Improvement Team to drive efficacy in clinical documentation, quality metrics, patient outcomes and reimbursement.
Reports to: Vice President, Organizational Excellence/Chief Compliance Officer
Functions & Responsibilities:
- Maintains current knowledge of home health compliance and regulatory requirements, including, but not limited to, completion of OASIS, PDGM, publicly reported quality metrics, patient outcomes and documentation requirements for efficient and accurate reimbursement of patient care.
- Reviews clinical documentation to ensure it meets education standards, state and federal regulations and best practice standards. Conducts quality and compliance audits as directed.
- Utilizes HCHB back-office (R2) application in order to support all aspects of revenue cycle workflow efficiency and documentation accuracy, including but not limited to, review/process, OASIS/coding, Plan of Care, Face to Face, Physician/Provider Medical Orders, Visit Documentation and Billing/Claims.
- Reviews clinical documentation and compiles data/trends for improvement in key performance and quality metrics. Provides feedback to Clinical Operations and Clinical Managers on areas for clinical documentation and/or quality metrics improvement.
- Provides real-time feedback to the Education Team on recommended areas for education focus to improve clinical documentation and OASIS completion and to support accurate quality metrics and improved patient outcomes.
- Serves as a subject matter expert (SME) for QI activities collaborating closely with Quality Improvement, Clinical Operations, Patient Admissions and revenue cycle departments to develop a continuous quality review process to optimize efficiency, improve documentation accuracy and promote best practices.
- Participates in VNA Care task forces/committees established for organizational improvements as appropriate or as requested. Demonstrates professional growth and development through continuing education and review of current literature.
- Upholds the compliance objectives and policies and procedures of the Foundation and Subsidiaries.
- Performs other related duties of a similar nature and complexity as directed.
Skills and Knowledge:
Education
- Bachelor of Science Degree in Nursing or Bachelor of Science Degree in Physical Therapy from an accredited program.
- OASIS Certification required.
- Diagnosis Coding Certification preferred.
- Licensed to practice in Massachusetts.
Experience
- Minimum 3 years recent experience in a related role with a certified home health organization (i.e. clinical operations, quality review, performance improvement and/or OASIS/coding review).
- Strong analytical, assessment and problem-solving skills. Ability to read, interpret and apply written regulations, guidelines and other materials.
- Strong interpersonal skills, including the ability to establish and maintain effective working relationships with individual at all levels.
