Home Health Quality Management Analyst PRN

Location Address:

Compensation Pay Range:

Summary:

How you grow, learn and thrive matters here.
* Educational and career development options, including tuition and certification reimbursement, scholarship opportunities
* Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern)
* Differentials for night/weekend shifts, higher education, certifications and various lead roles (for eligible positions)
* Malpractice liability insurance
* Loan forgiveness through the New Mexico Higher Education Department
* EPIC electronic charting system

Responsibilities:

In this role you will be responsible for Quality Assurance, Quality Improvement, OASIS/HIS Review, and Education Opportunities to ensure compliance with Federal and State regulations, Joint Commission Accreditation and Presbyterian Home Health and Hospice (PHH) policies and procedures.

• In conjunction with Home Health Director and Managers, analyze, plan, develop, coordinate, implement and evaluates compliance with accreditation, regulatory and licensing requirements, policies, procedures and protocols, and recommends educational opportunities.

• In conjunction with Directors, Managers, and Supervisors, analyze, monitor, coordinate, or conduct audits and/or surveillance to assess sustained compliance with regulations, policies, procedures, and protocols to determine if documentation and practice meets current clinical standards of care. Documents findings appropriately.

• Research and remain up to date with current industry standards and regulations, including current OASIS/HIS Guidance, and serve as a subject matter expert and staff resource for PHH. Collaborate with Operations to ensure accurate and consistent service provision, charting and data entry to result in timely processing of claims that meet regulatory and licensing requirements, policies and procedures and protocol requirements.

• Assist in evaluating, writing, and revising clinical and non-clinical policies/procedures for PHH.

• Collaborate with Education Department, Directors, Managers and Supervisors to recommend and or conduct clinical education, competency and training elements during orientation of new staff and ongoing support of current clinical staff.

• *Guide and assist Directors, Managers, Supervisors and Staff with utilization of Quality Assessment and Performance Improvement (QAPI) tools and processes. Develops materials and/or tools to assist staff with utilizing QAPI processes such as: audit tools, staff and/or patient educational newsletters, handouts, or training materials.

• Participates on committees, councils, PHS initiatives, or projects. Perform root cause analysis and/or risk assessments of adverse clinical events and or compliant investigations and serve as the PHH liaison for environment of care, emergency preparedness, and infection control oversight.

• Track, trend and analyze data, and submit reports with recommendations to Directors, Managers, and Supervisors to help PHH achieve and maintain compliance with accreditation, regulatory and licensing requirements, policies, procedures and protocols, through incorporation of Outcome-based and Quality Improvement (OBQI) practices. Upon request, participates in reviews of the patient's medical record and/or case conferences conducted by clinical teams, to present findings, and if necessary, offer recommendations for improvement. Coordinate mandatory regulatory reporting preparation, transmission and follow-up. Research and collaborate with staff to correct incomplete or incorrect data to finalize all required processing. Collaborate with Operations to help ensure accurate and timely processing of claims to meet regulatory requirements.

• Caring Practices: Incorporates clinical activities that create a compassionate, supportive and therapeutic environment for patients and staff with the aim of promoting comfort and healing and preventing unnecessary suffering.

• Clinical Judgment and Action: Uses clinical reasoning, which includes clinical decision-making, critical thinking, and a global grasp of the patient care situation, coupled with clinical skills acquired through a process of integrating formal and informal experiential knowledge and evidence-based guidelines to manage patient care.

• Clinical Inquiry: Uses high standards and evidence-based practices along with questioning, research and evaluation skills to provide informed and/or change practice Critical Elements of Clinical Inquiry Performance

• Supports process/quality improvement initiatives and incorporation into practice

• Follows and is informed on Department outcome measures

• Actively participates in changes in practice/roll outs

• Seeks advice and consultation on care from colleagues and interdisciplinary team

• Collaboration: Involves multidisciplinary team as well as patient/family to promote optimal and realistic goals and outcomes Critical Elements of Collaboration Performance

• Facilitation of Learning: Fosters patient/family learning to promote self-care using both formal and informal processes as applicable and at an appropriate level of understanding.

• Critical Elements of Facilitation of Learning Performance

• Self: Completes all required learning modules, programs in specified time

• Self: Uses available resources within system to enhance own continuous learning

• Self: sets and achieves learning and performance goals yearly

• Self: Consults, teaches, supports continuous learning with colleagues

• Self: Actively seeks learning/mentorship

• Response to Diversity: Uses holistic body, mind, spirit approach in provision of care by recognizing, appreciating, and incorporating cultural, spiritual, gender, race, ethnicity, lifestyle, socioeconomic, age, and value differences in practice.

• Critical Elements of Response to Diversity Performance

• Provides communication/ medical interpretation services for population served based upon language preference

Consistently provides care to population served with appreciation to diversity elements as designated above
Consistently communicates and documents patient diversity needs
Uses PHS established internal resources and vendors
System Thinking: Manages environmental and system resources across the healthcare system and community to meet patient/family needs or provision of quality care. Critical Elements of Systems Thinking Performance
Utilizes internal and PHS resources to provide evidence-based care including policy, protocols, procedures, approved specialty resources
Incorporates all patient safety technology, tools, protocols, communications, and initiatives to optimize a safe patient environment
Deploy in the clinical environment processes to enhance care efficiency, cost containment
Plan, maneuver, and deliver services/technology that are available within the system to meet the care needs of the patient
Negotiates within the system to achieve the care needs of the patient

Qualifications:

Education: Bachelors degree required- NURSING, PT, OT or SLP

Minimum 3 years of experience in home health required.
Licensed RN, Physical Therapist, Occupational therapist or Speech Language Pathology required.
OASIS Certification required for Home Health.

We're all about well-being, starting with yours.
Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.

Learn more about our employee benefits.

About Presbyterian Healthcare Services

Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.