Regulatory Quality Improvement Coordinator RN Hospice

AdventHealth•Altamonte Springs, FL

6d•Hybrid

About The Position

Our promise to you: Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 480 W CENTRAL PKWY City: ALTAMONTE SPRINGS State: Florida Postal Code: 32714 Job Description: Schedule: Full Time Shift: Monday-Friday 8am-5pm Location: Positions works out of one of our hospice offices (Altamonte Springs FL, Centennial CO, or Hinsdale IL). Opportunity to work hybrid on some days.

Requirements

Bachelor's (Required)
Certified Hospice and Palliative Nurse (CHPN) - EV Accredited Issuing Body
Registered Nurse (RN) - EV Accredited Issuing Body

Responsibilities

Coordinates all phases of record request processing, including ADRs, RAC requests, and Medicaid audits.
Develops and implements procedures and processes for record request management.
Instructs medical, clinical, and administrative staff in record request audit and processing procedures.
Coordinates with other departments to ensure adequate staff resources for timely audit and processing activities.
Establishes needs and communicates these needs to department managers or directors.
Prioritizes record processing to ensure submission deadlines are met.
Coordinates all levels of appeals processes for denied claims.
Coordinates with the Quality Service and Risk Coordinator to maintain tracking database integrity and provide reports to other departments.
Coordinates all communications with regulatory agencies.
Identifies employee educational needs related to regulatory scrutiny.
Partners with the Education Department to develop and provide education related to regulatory scrutiny.
Collects and analyzes data for application to the Quality Assessment and Performance Improvement (QAPI) process.
Identifies performance improvement opportunities in clinical documentation related to regulatory scrutiny.
Other duties as assigned.