Rn Clinical Quality Analyst

Description:Job Summary:

The RN Clinical Quality Analyst supports clinical business decisions, operational processes, and internal process improvements initiatives to improve reliability of care and outcomes for the organization. This position will incorporate clinical best practices by interpreting data, producing both long term and short-term activities to drive measurable solutions. The RN Clinical Quality Analyst creates analytical tools using an in-depth understanding of healthcare data such as patient, claims, financial and provider data. Assists and/or leads peer reviews by preparing case summaries, data collection and submission of clinical data to appropriate governing agencies.

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Accountability:

Reports to the Director of Quality & Education

Requirements:

Job Duties and Responsibilities:

Specific to Job Functions:

1. Maintains up to date knowledge of Federal and State hospice rules and regulations, LCD Guidelines, CHAP Standards of Excellence, Nevada Medicaid rules and regulations and CMS Conditions of Participation
2. Implements systems and policies as well as procedures for analysis of performance measurement data
3. Collects and analyzes data to identify trends, collaborating with the clinical teams on root cause analysis
4. Coordinates and/or leads action plans for improvement including follow up evaluation of data and organizational performance in meeting or exceeding quality benchmarks to ensure consistent improvement
5. Coordinates the completion of annual agency-wide systematic review and annual policy review
6. Plans and oversees the Quality Assurance and Quality Assessment Performance Improvement committee meetings
7. Coordinates reporting and distribution of all satisfaction surveys (CHAPS, etc.) for the Hospice program ensuring improvement agenda based on trends
8. Reviews weekly Unresolved Order Reports, CNA Visit Frequency report, RN Frequency Reviews reports with leadership and designated individuals
9. Generates and reviews monthly discipline late charting reports and distributes to appropriate leader
10. Gathers data from unusual occurrences and complaints and summarizing trending at designated timeframes for reporting in line with regulatory requirements
11. Assists with EHR quality and compliance education for clinical and non-clinical staff
12. Assists and maintains Clinical Laboratory Improved Amendments (CLIA) according to CMS standards for ProCare Hospice of Nevada’s laboratory
13. Monitors and assists with cost reduction strategies for supply ordering
14. Collaborates educational opportunities and activities for the development of quality and regulatory educational programs
15. Serves as a superuser of EHR system
16. Collaborates with IT and others in the Quality and Education Departments to ensure appropriate use of, and training in, the EMR system and other technologies utilized by the company
17. Completes quarterly state reports
18. Other duties as assigned

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General:

1. Adheres to patient rights, abuse reporting and confidentiality policies

2. Fosters and maintains an effective working relationship between peers, professional staff, and other personnel within the community

3. Understands the principles of palliative care/pain management within the Scope of Practice

4. Complies with all documentation policies and procedures

5. Completes appropriate documentation in a legible and timely manner

6. Attends scheduled staff meetings and or in-service training

7. Adheres to the departmental dress code requirements related to personal grooming and attire

8. Participates in Performance Improvement activities as requested

9. Demonstrates reliability by providing proper notification for absence or tardiness, participating in required meetings

10. Demonstrates ability to problem-solve and make decisions by assessing situations and considering alternatives, seeking guidance and direction as necessary, utilizing proper chain of command

11. Demonstrates effective time management skills by coordinating activities to achieve maximum productivity and efficiency, willingness to adjust or revise work schedules as requested

12. Assumes responsibility for on-going personal development and continuing education.

13. Stays current with all mandatory agency and regulatory requirements

14. Completes assigned projects within specified time frames

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Qualifications and Experience:

1. Graduate of an accredited school of nursing with a minimum of a current LPN licensure in the State of Nevada

2. RN preferred

3. Must have at least 5 years clinical nursing experience

4. 3 years in a hospice quality role preferred

5. Must have experience working with hospice accrediting bodies

6. Strong knowledge of Excel, Word, and PowerPoint required

7. Certification in Lean Six Sigma preferred or ability to obtain certification within specified time frame

8. Must be able to read, analyze and interpret business periodicals, professional journals, technical procedures, state, and governmental regulations

9. Must have reliable transportation, a valid driver’s license and maintain current auto insurance

10. Must successfully complete a background check pursuant to NRS 449.188 and NRS 179A.100

11. Must read, speak, write, and understand the English language

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Physical/Safety Requirements:

• Participates appropriately in emergency procedures (including disaster drills)
• Operates equipment in a safe manner and shares responsibility for communicating safety violations or unsafe practices to management
• Used general office equipment as intended
• Category 2 for potential exposure to blood/body fluids. (Does not usually require the performance of procedures or other tasks in the work routine that involve exposure to blood, body fluids or tissues, but Category 2 tasks may require the unexpected performance of these procedures)
• Utilizes appropriate PPE as needed
• Must be able to move intermittently throughout the workday
• Must have the strength and endurance require for sitting for lengthy periods of time
• Must be able to lift 10-25lbs.
• Must possess sight, hearing, and speech senses, or use prosthetics that will enable these senses to function adequately so that the requirements of this position are fully met

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

In compliance with the Americans with Disabilities Act of 1990, the employer will provide reasonable accommodations to meet the work environmental and physical demands listed above.