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Quality Assurance

3 months ago

Fairmont, United States Healthcare Management Solutions LLC Full time
Job DescriptionJob Description

DESCRIPTION

Healthcare Management Solutions, LLC (HMS) has an immediate opening for a Remote Medical Facility Surveyor Quality Assurance Analyst. This is not an information technology position.


The QA Analyst performs duties related to analyzing survey findings to ensure that Form CMS 2567s prepared by surveyors are consistent with the Principles of Documentation. Much of this work entails editing surveyor's written submissions for the Form CMS 2567s, monitoring surveyor performance, developing and utilizing training tools and methodologies to educate new surveyors and improve quality of existing surveyors.

Additionally, the Quality Assurance Analyst will assess citation patterns for individual surveyors to monitor surveyor performance and assess surveyor inter-rater reliability. The Quality Assurance Analyst is expected to identify indicators for tracking related to areas in need of improvement, collect and analyze data, meet with the OSP staff to discuss alternatives for change, assist with implementation of change or new methodologies to improve the survey process or surveyor performance, monitor and analyze change and report results.

Responsibilities:

• Participate in surveys as directed - typically one per month - travel is required

• Review, format, and edit Form CMS 2567s (Statements of Deficiencies) prepared by surveyors; be proficient with CMS data applications (ASPEN data reporting and retrieval systems) to facilitate exchange of survey documentation in a format that can be put into existing CMS systems; ensure that data entered in the ASPEN system to report survey findings is checked for appropriate formatting, accuracy, grammar and spelling; ensure that documents related to surveys forwarded to CMS are in the correct format and have been reviewed for appropriate formatting, accuracy, grammar and spelling prior to sending to CMS, the Regional Offices (ROs) or any agency outside of HMS

• Assess citation patterns for individual surveyors to assist with monitoring surveyor performance and inter-rater reliability; collect and analyze Quality Assurance Performance Improvement data related to the survey process and/or surveyor performance; identify indicators for tracking related to areas in need of improvement; meet with the OSP staff to discuss alternatives for change; assist with implementation of change or new methodologies to improve the survey process or surveyor performance; monitor change; analyze and report results

• Assist in providing and requiring additional training to maintain and improve proficiency of survey staff, including CMS approved updates; use CMS approved educational materials to train surveyors hired outside the time frame of scheduled CMS sponsored training and retraining of original team members who fail to maintain demonstrated competency in basic surveyor proficiency as required by CMS; assist in the evaluation of surveyor performance

• Ensure that Form CMS 2567s prepared by surveyors are submitted in a timely manner to CMS within 5 business days of exit interview; notify CMS when appropriate for extensions; coordinate with survey team leader as needed for review and/or completion of documentation prior to submission to the RO or State within the specified timeframes; maintain open communications with surveyors for clarification of survey findings; attend pre- and post-survey conference calls

• Solicit and analyze surveyor feedback for CMS provided training programs; provide a written summary to be included in monthly reports to CMS; assist CMS with analysis of survey findings to determine where surveyor training should be refocused, program clarifications are required, or provider re-education is necessary

• Attend the CMS annual surveyor training and any subsequent trainings as directed/required by CMS; attend CMS conference calls related to surveys, the surveyors, or the survey process


POSITION REQUIREMENTS

Desired Skills & Experience:

• Surveyor Minimum Qualifications Test (SMQT certification is required)

• Registered Nurse, Licensed Dietitian, Licensed Social Worker, or Generalist with at least 2 years of experience as a health care facility surveyor

• Knowledge of and experience with Quality Assurance Performance Improvement

• Educator experience

• Must be familiar with federal regulations related to Medicare and Medicaid requirements for health care providers

• Must possess strong grammar and writing skills

• Must possess and maintain a valid driver’s license


Minimum Education and Training Requirements:

Registered Nurse, Licensed Dietitian, Licensed Social Worker, or Generalist with at least 2 years of experience as a health care facility surveyor.

EOE STATEMENT

Healthcare Management Solutions, LLC has established an Affirmative Action Plan. HMS is deeply committed to the concept and practices associated with equal opportunity and affirmative action in all aspects of employment. HMS makes clear that all applicants will be treated without regard to race, color, sex, religion, national origin, age, disability, genetic information, sexual orientation, ancestry, marital status, changes in marital status, pregnancy or parenthood, gender, or gender identity or expression, military or veteran status, political affiliation, or any other protected characteristics under applicable law when the reasonable demands of the position(s) do not require distinction on the basis of age, disability, sex, marital status, changes in marital status, pregnancy, or parenthood.

This company does not tolerate unlawful discrimination in its employment practices. We recognize the value of diversity in our workforce and encourage all qualified candidates to apply. We thank all candidates who choose to apply, however, only those selected for a further interview will be contacted.

Equal Opportunity Employer/M/F/Vet/Disabled

HMS is an EEO/AA/E-Verify compliant and drug free workplace employer.