Piedmont Athens Regional Hospital - Athens, Georgia
Directs and implements QAPI program activities, utilizing appropriate statistical tools and methods to assure that trends are identified and addressed quickly and agency goals for patient quality, safety and satisfaction are attained.
Leads and manages prioritized performance improvement projects to achieve established targets.
Manages external/third party denials, processing appeals to reduce impact on agency resources.
Oversees agency wide OASIS completion, completion timeliness, transmission and related compliance activities to meet Federal, State, and the Joint Commission requirements regarding OASIS data submission.
Educates and coaches staff regarding findings from audits and other QAPI reviews.
Brings repeat performance progress to the attention of the Manager, Home Health or Director, Home Health.
Responsible for infection control and prevention activities for the agency, serving as the liaison to the PHC infection control staff.
Uses knowledge or International Classification of Disease (ICD) codes to oversee coding process.
Works with other managers and staff in areas of responsibility to improve operations performance.
Participates in administrative on call rotation for the agency.
KNOWLEDGE, SKILLS, ABILITIES
Working knowledge of Excel, Access or other data management or analytics programs.
Team facilitation skills.
Possess in depth working knowledge of Medicare Home Health, Medicaid, and commercial insurance payers, as well as working knowledge of CMS home health regulations and Joint Commission Home Health Standards.
Strong critical thinking and analysis skills with large amounts of data.
Ability to multi-task and shift focus frequently between tasks to complete work without error.
Able to apply interpretive guidelines of the CMS OASIS assessment instrument to actual patient assessments or to the evaluation of clinical documentation assessments performed by other clinicians.
Knowledge of the International Classification of Disease (ICD) coding guidelines. Uses concepts of coaching, counseling, team building, and empowerment.
Demonstrates effective leadership skills in directing, monitoring and appraising performance of staff.
Well-informed of improvement concepts and clinical competency in area of responsibility.
Self-directed and able to manage multiple projects, producing high quality work.
MINIMUM EDUCATION REQUIRED:
Graduate of a nursing program.
MINIMUM EXPERIENCE REQUIRED:
Three years of experience in direct patient care in home care plus one year of experience in utilization review, data analysis methods, staff education, or quality roles required.
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
Current License in the State of Georgia as a Registered Nurse. Valid Georgia Driver’s License.