Quality Monitor Nurse

TX-HHSC-DSHS-DFPS•Denton, TX

7d•$6,800 - $6,800•Remote

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) department is driven by its mission to deliver quality, cost effective services to Texans. The Quality and Program Improvement’s Quality Monitoring Program (QMP), Quality Monitoring Unit (QMU) seeks a highly qualified candidate to fill the position of Nurse III (Quality Monitor Nurse). The QMP QMU helps address conditions in Texas Nursing Facilities (NFs) that could be detrimental to the health, safety, and welfare of residents. The ideal candidate thrives in an environment that emphasizes teamwork to achieve goals, excellence through high professional standards and personal accountability, curiosity to continuously grow and learn, critical thinking for effective execution, and integrity to do things right even when what is right is not easy. The Quality Monitor Nurse (QMN) reports to the Quality Monitoring Unit Regional Nurse Manager. This position makes a significant contribution to MCS’s mission by conducting monitoring visits in Texas nursing facilities. The QMN utilizes their nursing expertise and knowledge in the area of nursing to assess conditions that could place facility residents’ health, safety, and welfare at risk and assist providers in improving systems. This position must be able to apply their complex knowledge of nursing practice, their critical thinking skills as well as the rules outlined in the Texas Nursing Practice Act. The Nurse III will be familiar with local, state, and federal laws and regulations relevant to long-term care. The QMN works under limited supervision, with considerable latitude for the use of initiative and independent judgment. Prepare a complex narrative report after each QM visit, RRT visit, in-service, telephonic or virtual communication with a nursing facility. This report includes a detailed narrative of any pertinent findings, any actions taken, and any recommendations made at the conclusion of a visit. The QMN will serve as team coordinator on Rapid Response Team (RRT) visits to coordinate and monitor facility systems through observations, interviews and record reviews identifying facility strengths and implementation of changes and/or opportunities for improvement. The QMN communicates on a complex level with others (internally or externally) to provide clinical information, answer inquiries, address issues, and/or resolve problems. The QMN will maintain collaborative relationships with colleagues and team members, mentor, train, and supervise the work of others in the context of a QM visit as needed, and assist management with developing program policies and procedures, nursing guidance/manuals; and planning program activities in accordance with program objective and goals.

Requirements

Current Texas Registered Nurse license (in good standing).
Graduation from an accredited four-year college or university with major coursework in nursing or an associate degree in nursing with at least two years of nursing experience, required
A minimum of 3 years of nursing experience is required.
Knowledge of local, state, and federal laws and regulations relevant to long-term care.
Knowledge of modern office management practices and procedures and technology tools such as Microsoft Office, SharePoint, and Teams productivity tools.
Knowledge of Medicaid, waiver programs, long-term care, local, state, and federal legislative processes, and/or long-term care programs and policies.
Skill in researching, creating, analyzing, monitoring, and evaluating complex clinical issues.
Skill in communication and public speaking.
Skill in managing multiple and competing priorities.
Skill in identifying problems, evaluating alternatives, and negotiating and implementing solutions.
Skill in working collaboratively and cooperatively with diverse groups.
Skill in identifying trends, concerns, and recommending opportunities for improvement and areas of excellence.
Skill in paying attention to detail and the ability to implement creative solutions to problems.
Skill in working with diverse groups and interests, resolving conflicts, building consensus and problem solving.
Ability to work collaboratively across MCS to accomplish objectives.
Ability to evaluate and interpret policies and procedures.
Ability to interpret long-term care facility regulations.
Ability to organize and present information effectively, both orally and in writing.
Ability to plan, assign and/or supervise the work of others.
Ability to gather, assemble, correlate, and analyze facts to interpret and apply policies and procedures.
Ability to communicate effectively, teach and provide oral presentations.
Ability to balance team and individual responsibilities.
Ability to exercise judgment and work independently with moderate direction.
Ability to conduct literature reviews and analyze complex information to update nursing related evidence based best practices technical assistance material.
Requires 80% travel across the state of Texas and overnight stays, including hours other than 8-5 and days other than Monday-Friday.
Requires a reliable motor vehicle, a current, valid Texas driver's license and valid insurance.

Nice To Haves

Experience working in Long-Term Care Nursing Facilities is preferred.

Responsibilities

Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned. Works collaboratively across MCS to identify innovative and effective solutions.
Prioritizes, Plans, and performs a variety of technical assistance, research, review of facility policies and programs, and administrative activities during off-site and on-site Quality Monitoring (QM) and Rapid Response Team (RRT) visits including assessment of the delivery of services. Gathers and analyzes data from a number of sources to plan and prepare for quality monitoring visits in Medicaid-certified facilities. The information gathered during the pre-visit preparation assists in determining the focus area for the QM visit, including clinical topics and systems that will be evaluated during the visit. As a member of the RRT, using their clinical expertise through observations, record reviews and interviews, shares the findings with other team members and assists the nursing home provider in developing action plans for the areas needing improvement to meet minimal standards. Uses his/her extensive knowledge of nursing to evaluate all nursing facility systems including Resident Rights, Abuse, Neglect and Exploitation (ANE), Quality of Life, Quality of Care, Assessments and Care Planning, and Emergency Preparedness. Reviews resident records and observes clinical care practices to ensure minimum standards and EBBP are being met, while providing recommendations regarding any nursing issues identified for facility system changes. Through record review, observations and interviews with facility residents and staff, the nurse quality monitor gathers valuable information that can help him/her work in partnership with the facility to identify strengths and opportunities for improvement, ultimately improving the quality of care and quality of life for the facility’s residents. Completes assessments/worksheets during the visit, accurately documenting all findings to determine the facility’s need for technical assistance using his/her complex skills and knowledge to identify the educational needs of the facility’s staff. (45%)
Reviews policy/procedures and performance reports to determine if the facility's systems are consistent with Evidence Based Best Practice (EBBP). Uses his/her complex knowledge of nursing to assess residents’ clinical health needs and recommend changes to facility staff, in accordance with EBBP. Provides in-service education and other training to facility professional staff regarding EBBP practices. Assists with the development and updating of program policy/procedures, EBBP standards, and educational programs. (20%)
Completes and documents accurate observations, record reviews, and interviews. Prepares a complex narrative report after each QM visit, RRT visit, in-service, telephonic or virtual communication with a nursing facility. This report includes a detailed narrative of any pertinent findings, any actions taken, and any recommendations made at the conclusion of a visit. Communicates accurate information, findings, recommendations, and technical assistance to the facility administrator and staff. Disseminates appropriate educational tools and materials to provide high-level technical assistance. (20%)
Serves as team coordinator on RRT visits to coordinate and monitor facility systems through observations, interviews and record reviews identifying facility strengths and implementation of changes and/or opportunities for improvement. Communicates on a complex level with others (internally or externally) to provide clinical information, answer inquiries, address issues, and/or resolve problems. Maintains current knowledge in assigned areas by attending meetings, seminars, or other training and by continually reviewing program policies, procedures, and any changes. Conduct literature reviews and analyze complex information to update nursing-related EBBP technical assistance material. (10%)
Maintains collaborative relationships with colleagues and team members. May mentor, train and supervise the work of others in the context of a QM visit, provide orientation to peers and others as needed. Assists management with developing program policies and procedures, nursing guidance/manuals, and planning program activities in accordance with program objective and goals. (5%)