Home Health Quality Management Analyst

Presbyterian Healthcare Services

8d•$58,074 - $88,670•Remote

About The Position

Build your Career. Make a Difference. Presbyterian is hiring a skilled Home Health Quality Management Analyst to join our team How you grow, learn and thrive matters here. • Educational and career development options, including tuition and certification reimbursement, scholarship opportunities • Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern) • Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions) • Malpractice liability insurance • Loan forgiveness through the New Mexico Higher Education Department • EPIC electronic charting system Presbyterian exists to improve the health of patients, members, and the communities we serve. We are 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, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses. Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. We're Determined to Support New Mexico's Well-Being | Presbyterian Healthcare Services Here, we’re committed to a different way to make a difference. 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, nurses, employees, board members, and volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than one in three 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. Connect with the Presbyterian Recruiting Team! FIRST, we want to make sure you’re in the right place. To provide you with the most accurate job recommendations and updates, please choose the appropriate Career Portal: For Physicians, Midlevel Providers and Advanced Practice Professionals, connect with us here: Provider Career Site For Nursing Professionals (LPN & RN), connect with us here: Nursing Career Site For All Other Career Types, please continue the sign up process on this page

Requirements

THIS ROLE REQUIRES ONE OF THE FOLLOWING DEGREES: Registered Nurse, Occupational Therapist, Physical Therapist, Speech Language Pathologist
At least three (3) years of Home Healthcare Experience in the last 5 years.
Bachelors degree required in one of the following: Registered Nurse, Physical Therapy, Occupational Therapy or Speech Language Pathology.
Minimum 3 years of experience in home health in the last 3 years required.
Licensure in one of the following will be considered and required:
Current Licensure in the State of New Mexico as a Registered Nurse
Current Licensure in the State of New Mexico as a Physical Therapist
Current Licensure in the State of New Mexico as a Occupational therapist
Current Licensure in the State of New Mexico as a Speech Language Pathology
OASIS Certification required within 18 months of hire for Home Health

Responsibilities

In conjunction with Home Health Director and Managers, analyze, plan, develop, coordinate, implement and evaluates compliance with accreditation, regulatory and licensing requirements, policies, procedures and protocols, and recommends educational opportunities.
In conjunction 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. Documents findings appropriately.
Research and remain up to date with current industry standards and regulations, including current OASIS/HIS Guidance, and serve as a subject matter expert and staff resource for PHH.
Collaborate with Operations to 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 during orientation of new staff and ongoing support of current 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, 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.

Benefits

Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
Malpractice liability insurance
Loan forgiveness through the New Mexico Higher Education Department
EPIC electronic charting system
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.

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