Quality Improvement Specialist

Posted 8 Days Ago
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Port Orange, FL, USA
In-Office
Mid level
Healthtech • Telehealth
The Role
Reviews and validates hospice patient-care data for CMS quality reporting, including HIS and HOPE submissions. Analyzes quality measures against standards, identifies data deficiencies, monitors validation reports, corrects submission errors, and prepares performance reports for leadership. Supports quality assessment and performance improvement initiatives, audit criteria development, staff education, regulatory compliance, and audit reporting.
Summary Generated by Built In
Day (United States of America)

Quality Improvement Specialist

Responsible for review/extraction of patient care data related to the Hospice Quality Reporting Program (HQRP) entered into the electronic medical record to ensure accuracy and completeness of information prior to submission to Centers for Medicare and Medicaid Services (CMS).
Responsible for coordinating the collection of various quality measure data, analyzing this data for comparison to standards, and identifying areas in need of improvement.

- Graduate of an accredited School of Nursing. RN or LPN licensed in the state of Florida.

- A minimum of 3 years of clinical experience in hospice or related field.

-- Previous experience in quality improvement highly desirable.
- Good communication and organizational skills.

- Ability to work independently and collaboratively with multiple departments and customers.

- Ability to organize and analyze data and summarize key issues relating to quality care and improvement.

- Proficient in navigating electronic medical records, use of Excel, Adobe, Word.

- Knowledge of state, federal and other regulations required for compliance with governmental audits.

- Responsible for submitting patient care data within defined time frames for each of the CMS required elements, including but not limited to the Hospice Item Set (HIS) and/or the Hospice Outcomes and Patient Evaluation (HOPE) data

- Responsible for review of HIS/HOPE validation reports to verify acceptance or rejection of records/monitor for any warnings or fatal errors

- Responsible for identifying any inaccuracies in a submitted record, and taking steps to correct in the CMS system

- Responsible for remaining current with any updates/revisions by CMS to the HIS/HOPE/HQRP processes

- Identifies deficits related to HQRP data review, and create appropriate education/feedback on the team and/or individual level

- Responsible for obtaining and reviewing monthly and quarterly HQRP reports in the CMS database to monitor for organizational performance and reporting to quality manager/senior leadership

- Assists with the implementation of the Quality Assessment Performance Improvement program

- Assists in the development of valid criteria for audits

- Compiles reports and statistics obtained from audits and provides them to the quality manager

OTHER REQUIREMENTS AND SPECIFICATIONS: 

Supervision required: Direction/guidance is obtained from Quality manager and Director of Quality as needed. Working relationships with other departments are maintained for the purpose of sharing knowledge, resources, and ideas.

Contacts: Contact is made with internal/external customers daily or as needed.

Working conditions: Indoor office environment with offsite visits as needed. Day shift, but may require some after hours on occasion.

Skills Required

  • Graduate of an accredited School of Nursing
  • Current RN or LPN license in the state of Florida
  • Minimum of 3 years of clinical experience in hospice or a related field
  • Previous quality improvement experience
  • Good communication and organizational skills
  • Ability to work independently and collaboratively with multiple departments and customers
  • Ability to organize and analyze data and summarize quality improvement issues
  • Proficiency navigating electronic medical records and using Excel, Adobe, and Word
  • Knowledge of state, federal, and other regulations for governmental audit compliance
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The Company
5,000 Employees
Year Founded: 1928

What We Do

Halifax Health is a community healthcare leader serving residents and visitors in Volusia and Flagler counties, Florida, for over 95 years. It operates a system of hospitals and professional centers, including a tertiary hospital, community hospital, freestanding emergency departments, and specialized psychiatric and cancer treatment services. The organization is dedicated to providing exemplary, patient-centered medical, emotional, and spiritual care throughout East Central Florida.

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