RN Quality/Regulatory Nurse - Home Health

Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:

The Quality/Regulatory Nurse is responsible for ensuring the timely and accurate review of records, performing data analysis on reviews and reporting outcomes documented. In addition the Quality/Regulatory Nurse is responsible for ensuring TJC and DHHS Survey Readiness continually, leading efforts to coordinate services and service delivery. Provides coordination and participates in QAPI programs, MDI efforts, peer review, infection control, value based purchasing and patient safety initiatives. Provides competent clinical nursing care consistent with professional standards. Responsible for coordinating and delivering patient care utilizing the nursing process in the home or in-patient hospice settings.

Responsibilities:

Participates on committees related to safety, quality and regulatory matters. Collaborates with physicians, clinical staff and leadership for quality/regulatory issues. Reviews and proposes changes to policies related to Hospice, in compliance with CMS, TJC or other accrediting agencies. Maintains organizational awareness of TJC and CMS requirements.
Assists with Home Care/Hospice/SECU continual readiness for accreditation surveys. Performs clinical chart reviews/audits, prepares various quality and regulatory reports as needed to insure ongoing compliance with CMS, TJC and other accrediting agencies. Completes in-home and onsite reviews of patient care to insure compliance with all regulatory requirements as well as compiling reports from reviews. Performs medical record reviews accurately and timely.
Designs and evaluates processes and policies/procedures to improve quality and regulatory compliance for Home Care/Hospice/SECU programs.
Participates in OASIS submission to include review and revisions of necessary components to insure appropriate and timely Quality Submissions to CMS. Prepares Hospice Item Set Data and Service Intensity Add-On statistics for submission to CMS and submits as required. Reviews Home Health Care and Hospice Care Plans to insure appropriate and complete documentation in compliance with regulatory and credentialing agencies.
Participates in on-call rotation for Home Care/Hospice/SECU. Works as staff nurse as needed to support patient care. Prepares and presents monthly education to staff on regulatory compliance related to COP's and TJC standards as well as ongoing QAPI program.
Completes pre-billing audits to insure all necessary components are present.
Monitors and reports components of the Infection Prevention Program. Manages clinical and quality WQ's in the EMR and corrects issues to insure timely billing. Insures MSPQ is completed on all appropriate patients. Completes clinical chart reviews for ADR requests and appeals.

Other information:
Education Requirements:
* Nursing degree required. BSN preferred.
Licensure/Certification Requirements:
* Licensed to practice as a registered nurse in the state of North Carolina.
* BLS
Professional Experience Requirements:
* Prefer prior experience in hospice of home health.
Knowledge/Skills/and Abilities Requirements:

Legal Employer: NCHEALTH

Entity: Johnston Health

Organization Unit: Home Health -

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $27.89 - $40.09 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: US:NC:Smithfield

Exempt From Overtime: Exempt: No

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.