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Quality Compliance Program Liaison

4 months ago

Landover, United States Children's National Hospital Full time
This position is PRN (Per Diem).

The Quality Compliance Program Liaison leads clinical quality outcome activities at HSC Home Care, LLC and HSC Health & Residential Services by supporting clinical business decisions, operational processes and internal process improvement initiatives to improve reliability of care and outcomes of the best healthcare services while managing costs. He/she evaluates, develops, analyzes and implements strategies to enhance clinical, administrative and process outcomes, in collaboration with HSCHC Leadership to ensure delivery of exceptional quality health care and services. Works collaboratively with the HSCHC Management Clinical teams to ensure that desired outcomes are achieved while minimizing and /or mitigating clinical and financial risk. He/She participates in monitoring the quality and compliance of clinical documentation and participates in organization-wide projects that achieve and maintain an effective quality and compliance program. This role demonstrates initiative and creativity in addressing compliance, quality and client safety issues related to MD & DC State and Federal regulations, Accreditation and CHAP standards.

Qualifications:
Minimum Education
BSN Bachelor's Degree in Nursing preferred, Master's Degree (MS, MSN, MPA or MPH) strongly preferred. (Preferred)

Minimum Work Experience
2 years QUALIFICATIONS:
Required Experience:
-At least 2 years of experience in developing, implementing, and evaluating clinical program standards & initiatives inclusive of clinical program evaluation.
-At least 3 years of professional clinical experience.
-Must have working knowledge of Community based practices (home health).
-Ability to work under pressure, with strong organizational and analytical skills.
-Demonstrated project management skills with the ability to handle multiple concurrent projects.
-Ability to work effectively with providers and multidisciplinary teams across departmental lines.
-Familiar with CMS/DOH/DHMH/CHAP regulations.
-Excellent written and verbal communication skills.
Intermediate to advanced knowledge of MS Office Suite (Word, Excel, Access, Powerpoint and Outlook). -Data collection and analysis skills required; skills working with relational databases preferred.

Required Licenses and Certifications
Registered Nurse License/Certifications:
-Valid RN license in the District of Columbia and/or Maryland or any combination as required based on work location(s) preferred. OR applicable work experience. (Preferred)

Job Functions

Essential job duties: Accreditation, Licensing, Survey Readiness - Participates in establishing all submissions, deadlines and reporting activities as required by CHAP standards, CMS, DC DOH, MDDOH, MDMA. Enforcing compliance standards for the organization's accreditation standards, on a federal, state and local regulatory requirements level.

1. Assists operational and clinical leaders, including leadership to monitor home health compliance standards through standard data review ensuring quality compliance improvement information is reported in a timely manner.
2. Conduct chart audits/reviews ensuring compliance and develop action plans to improve identified areas of opportunity for quality improvement. In-home client SPOTT visits and office inspections, recommend interventions and education to improve client care services, coordinates with staff to resolve documentation-related billing issues. Conduct prebilling claims review and prepare report to identify denial trends for compliance audit purposes.
3. Develop clinical training pathways and optimal staff & client outcomes. Participates in the assessment, monitoring and evaluation of CHAP standards, Federal and State regulations including Home Health COP's to ensure compliance.
4. Monitors national Patient Safety goals and organizational quality plan to identify trends and gaps in regulatory compliance. Monitors safety and event reporting, ensures all events are entered and appropriate follow up is completed.
5. Collaborates with leadership to identify Home Health educational materials for staff to ensure home health compliance, accuracy and documentation effectiveness. Advises leadership, as well as colleagues utilizing knowledge and acts as a consultant including group education when needed.
6. Maintains expertise & professional growth through ongoing education related to current Home Health practice, quality improvement trends, ongoing competency with quality improvement models - such as IHI Model for Improvement, TeamStepps, and Lean Management Systems.
7. Maintains a strong working knowledge of the principles and practices of project and change management, including standard work, planning and organization as well as metrics for project success and sustainability.
8. Family advocate, compile Client/Caregiver satisfaction surveys, report to appropriate committees and explore ways to improve in collaboration with leadership on feedback.
9. Demonstrate teamwork by providing coverage in the department as needed. Attends and participates in organization and external meetings as directed.
10. Conducts programmatic investigations of serious incidents/allegations and provide to the COO as directed. Creates and maintains programmatic dashboards to report progress timely on QI outcomes, identify gaps in current performance and strategies to achieve improvement with sustainability.
11. Supports team committees' activities (Agenda, Minutes, Reports). Serves as Client Safety committee chair inclusive of Emergency Preparedness and leads for both organizations.
12. Oversees credentialing and maintenance of organizational personnel training and competency records to ensure all agency personnel comply with required trainings.
13. Partners with organizational leaders to follow-up on internal and external audit reports and assist in the development of corrective action plans and organizational responses. Participates in strategic planning and formulation of departmental long term and short-term objectives.
14. Review, update and maintain standard operating procedural manuals. Uploads electronic policy and procedure to organization's portal.
15. Develop/update analytical tools using an in depth understanding of healthcare operations data (e.g. client, claims, financial, clinical and provider data) and employ quantitative data analysis methodology to interpret and share results with key stakeholders. Integrates quality data across organization to bolster client safety.

Organizational Accountabilities
Organizational Accountabilities (Managers)
Leadership Excellence
  • Demonstrates understanding of quality of service and collaborates with co-workers to ensure excellence is achieved
  • Innovates through improvement of care and/or efficiency of operational processes.
  • Dedicated to a standard of performance excellence and high quality
Collaboration
  • Creates a safe environment that encourages brainstorming, creativity and "out-of-the-box" thinking
  • Encourages a diverse group of people to communicate effectively and embrace creative thinking
  • Drives the collaborative efforts of the team to achieve goals in the most effective and efficient way
  • Demonstrates listening and feedback skills
Leadership Skills
  • Proactively assumes responsibility and accountability for results to include management of organizational change
  • Empowers staff in ensuring a culture of transparency, fairness, respect and excellence
  • Strategically aligns operational and tactical objectives to drive business results.
  • Encourages collaboration with team members based on trust, mutual respect, consistent visible support, and open and honest communication.
Supervisory Responsibilities
Blood Borne Pathogen Exposure
Protected Health Information Access Level
Working Environment
Physical Requirements
Travel Requirements