Regulatory Quality Improvement Coordinator RN Hospice

1057 AdventHealth Home Health and Hospice Inc; United States; On-site; USD 61,000 - 98,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Time Off from Day One

403-B Retirement Plan

Parental Leave

Career Development

Whole Person Well-being Resources

Mental Health Resources and Support

Pet Benefits

Job summary

AdventHealth Home Health and Hospice Inc is seeking a full-time RN to coordinate record requests and audits across Altamonte Springs and Ormond Beach, with travel between locations. Responsibilities include developing procedures, instructing staff, and coordinating with regulatory agencies.

The role requires nursing expertise, Florida RN licensure, and experience with Medicare/Medicaid regulations. A focus on performance improvement and interdepartmental collaboration is essential.

Qualifications

• RN with valid Florida license.
• 5+ years of nursing experience; hospice experience preferred.
• Knowledge of Medicare/Medicaid regulations.
• Experience with performance improvement initiatives.

Responsibilities

• Coordinate all phases of record request processing and audits.
• Develop and implement procedures for record request management.
• Instruct staff on record request processing procedures.
• Coordinate with departments to ensure adequate staff for timely audits.
• Maintain tracking database and provide reports to other departments.
• Coordinate communications with regulatory agencies.

Skills

Nursing knowledge

Regulatory compliance

Office software

Education

Bachelor's in Nursing or related field

Tools

HomeWorks

Microsoft Office Suite

Job description

Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family:

• Medical
• Dental
• Vision Insurance
• Life Insurance
• Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule: Full time Shift: Day (United States of America) Address: 480 W Central Pkwy City: Altamonte Springs State: Florida Postal Code: 32714

Job Description

Schedule: Full Time Days Monday - Friday 8am-5pm Location: Sits in our Altamonte Springs or Ormond Beach office with travel between the 2 locations. Coordinates all phases of record request processing, including ADRs, RAC requests, and Medicaid audits. Develops and implements procedures and processes for record request management. Instructs medical, clinical, and administrative staff in record request audit and processing procedures. Coordinates with other departments to ensure adequate staff resources for timely audit and processing activities. Establishes needs and communicates these needs to department managers or directors. Prioritizes record processing to ensure submission deadlines are met. Coordinates all levels of appeals processes for denied claims. Coordinates with the Quality Service and Risk Coordinator to maintain tracking database integrity and provide reports to other departments. Coordinates all communications with regulatory agencies. Identifies employee educational needs related to regulatory scrutiny. Partners with the Education Department to develop and provide education related to regulatory scrutiny. Collects and analyzes data for application to the Quality Assessment and Performance Improvement (QAPI) process. Identifies performance improvement opportunities in clinical documentation related to regulatory scrutiny. Performs other duties as assigned.

Knowledge, Skills, and Abilities

• Knowledge of nursing skills in the performance of duties in compliance with the legal and ethical parameters established and based on the level of education and certification attained by the employee.
• [Required] Knowledge of laws, regulations and standards applicable to the provision of hospice care and services, including but not limited to the Medicare Conditions of Participation, Medicaid regulations, Agency for Health Care Administration regulations and NHPCO Standards of Practice.
• [Required] Knowledge of clinical software systems (e.g., HomeWorks).
• [Required] Knowledge of basic to intermediate application of Microsoft Office Suite including, Word, Excel, PowerPoint, Outlook and Access, as well as internet software.
• [Required] Knowledge of internet research methods.
• [Required] Ability to follow standard precaution guidelines for infection control, including when providing patient care.

Education

Bachelor's [Required] Field of Study: in Nursing, Health Care, or related field is required. An equivalent combination of education and experience may be substituted at the discretion of the Administrator.

Work Experience

• 5+ experience in the field of nursing is required, including minimum of 1 year of hospice experience is required. [Required]
• Experience related to performance improvement, quality assurance is preferred.
• Hospice and/or home health care management experience is preferred [Preferred]

Licenses and Certifications

• Registered Nurse (RN) [Required]
• Certified Hospice and Palliative Nurse (CHPN) [Preferred]

Physical Requirements

Pay Range: $61,360.00 - $98,176.00

Background Screening Requirement (Florida Law) Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Every day, our fellow team members show up to work, unified by one shared mission: Extending the Healing Ministry of Jesus Christ. As a faith-based health care organization, our story is one of hope as we strive to heal and restore the body, mind and spirit. Though our facilities are spread across the country, this unwavering belief binds us together. Across every office, exam and patient room, we’re committed to providing individualized, holistic care. This is our Christian mission, and it inspires us to help make communities healthier and happier.