Hospice Clinical Quality Coordinator

Presbyterian Homes & Services•Roseville, MN

About The Position

Presbyterian Homes & Services -Optage Hospice is seeking a full time, licensed Clinical Quality Coordinator to join its team. The Clinical Quality Coordinator is responsible for providing comprehensive planning, monitoring, implementation, and evaluation of the Quality Assurance and Process Improvement (QAPI), clinical compliance activities, clinical chart review and Emergency Preparedness for Optage Home Care. The Clinical Quality Coordinator serves as an internal expert for a wide range of activities including client assessment and clinical documentation policies and regulation, patient/family satisfaction, agency outcomes, clinical benchmarking data (QAPI, Home Care Compare, SHP), infection surveillance, patient satisfaction, and other quality initiatives. The Clinical Quality Coordinator has responsibility as a member of the Optage Hospice leadership team to provide guidance and feedback to Hospice staff regarding clinical assessment and documentation, participate in the planning and implementation of strategies and programming that assure high quality care and services while achieving short and long-term operational goals and objectives for the division.

Requirements

Professional license in clinical practice related to Hospice with current licensure with the State Board in state(s) in which he/she practices.
Must have a minimum (2) years of experience Home Care.
Demonstrated knowledge of Hospice services and regulations of MDH and CMS.
Experience in quality improvement / quality assurance.
Must possess knowledge of governmental and other regulatory standards, requirements, and guidelines related to quality improvement, clinical documentation, and Oasis Process.
Must demonstrate strong working knowledge of ongoing monitoring techniques (including criteria development and statistical analysis), care delivery in community, total quality management principles, tools, and techniques.
High initiative and ability to lead interdisciplinary teams and coordinate and manage quality improvement and clinical documentation requirements efficiently and effectively.
Strong interpersonal, organizational, and communication skills. Team player willing to take direction and responsibility for meeting specified objectives.
Excellent interpersonal, communication, and organizational skills.
Proficiency with Microsoft Office and other software applications related to Quality benchmarking and Oasis Process.
Demonstrated compatibility with PHS’ mission and operating philosophies.
Demonstrated ability to read, write, speak, and understand the English language to communicate with all customers.

Responsibilities

Direct and ensure the development and completion of the OASIS client assessment process with other health professionals consistent with regulations and established clinical best practices. Ensure timely, accurate and complete assessment of the client’s health and functional status during the entire assessment period. Other specific areas of responsibility include but are not limited to:
Maintain an accurate schedule and assignments of all Oasis assessments to include the proper reference dates throughout the client’s stay. Coordinate schedule/F2F date. Conduct assessments as needed.
Maintain the frequent and accurate data entry of client information into appropriate computerized OM programs. Manage Oasis and coding submissions.
Audit HHCAHPS and review all expedited appeals. Perform concurrent Oasis review to assure appropriate Case Mix category is achieved through the capture of appropriate clinical information.
Perform monthly QI/QM review and provide recommendations to IDT and Case Managers.
Determine denials/communications at IDT, track clients in 30 day window, monitoring regulatory compliance for completion.
Transmit, review, validate reports and communicate problem areas for correction to Clinical Supervisor team and Home Care Administrator.
Capture custodial vs skilled care assessment.
Include ICD10 DX prioritization.
Ensure F2F compliance documentation in each 485 clinical record.
Ensure the development of the written plan of care for each client based on the client assessment.
Participate in the interdisciplinary team process (IDT) to communicate opportunities, facilitate efficient and effective care plan development and management. Collaborate with the interdisciplinary team to identify significant change in Oasis scoring and educate the team on best practice. Specifically communicate (but not limited to): Oasis C2 changes and scoring, changes to skilled services, ADR readiness and F2F clinical documentation to support skilled and medically necessary need, significant change in status assessments.
Develop, implement and maintain established policies, procedures and practices related to the development, use and implementation of the client assessment (Oasis) and care plan. Ensure policies and procedures are understood and implemented by staff. Use the quality management process to assure accurate completion of client assessments, care plans and care delivery processes. Maintain all required documentation in accordance with regulations and established clinical best practices.
Audit client records and supporting documentation to include data analysis, evaluation and communication of audit findings. Conduct regular audit of OMR process including validation of coding documentation, and evaluating outcomes per policy. Maintain monitoring systems and processes to ensure compliance with regulations and established clinical best practices. Responsible for key measure management.
Lead the OMR/F2F process and staff to ensure high quality care and service for clients (physical, mental, emotional, social and spiritual) and maintains their independence and dignity to the highest degree possible. Establish and maintain effective communication systems with all case managers.
Assist in providing employee training related to the client assessment process. Train and support the performance of the Optage Case Managers and other health with respect to client assessments and OASIS completion. Coach and assist staff to achieve desired outcomes and individual development.