Gentiva Hospice
Director Clinical Quality - East Region
Gentiva Hospice, Atlanta, Georgia, United States, 30383
Overview
The
Director of Clinical Quality
reports to the Vice President of Clinical Quality. The Director of Clinical Quality is responsible for direct involvement, chart reviews, IDG attendance and oversight of corrections needed. This role evaluates needs in the individual branch and establishes a plan to implement changes and overall improvement of documentation. This role helps develop a process of accountability to ensure improvement of overall quality. The Director of Clinical Quality will develop, when applicable, and direct the implementation of corrective action plans in branches as a result of unfavorable internal survey or external conditional survey outcomes.
Essential Functions of Position
Upon initiation of a CMS audit which may include Targeted Probe and Educate, UPIC,SMRC and/or any other audit activity, theDirector of Clinical Qualityalong with the VP of Clinical Quality will analyze the office risk level and develop an action plan. This will include but not limited to education, audit initiation, interdisciplinary group review, calls to assist virtually and/or possible on-site visits.
On-going assessment of the branch will be provided on a regular basis and weekly reports to the VP of Clinical Quality will be provided to analyze outcomes and possible changes in plan.
Aids with claim denials and in the resolution of claims.
Collaboration with the Director of Clinical Operations and Vice President of Clinical Operations would be maintained to ensure coordination is maintained and delineate roles and responsibilities related to support and education actions.
Ensures compliance with local, state and federal regulations and accreditation standards. Provides support, direction and feedback to staff during the clinical compliance process. May delegate responsibilities to ensure follow-up to resolution of each action item identified.
Proactively assesses office performance and implements changes to prevent noncompliance. Communicates with up line manager, Chief Clinical Officer, Chief Compliance Officer, legal department, Utilization Management and other corporate resources as appropriate to address/resolve issues.
May work as support or back up to a Director of Clinical Operations at times when increased survey response is needed. This role would be a resource to help manage and contribute when appropriate.
Direct and monitor resolution of identified deficiencies in conditional surveys.
Support offices with quality measures in all areas which may include but not limited to claim denials, quality metrics, quality reviews and quality care.
About You Specialized Knowledge/Skills:
Extensive knowledge in the areas of documentation, and the interpretation and application of regulations and performance improvement standards required.
Must be knowledgeable of federal, state, and local regulations, as well as federal guidelines for hospice services. Knowledgeable in OSHA regulations.
Experience building and leading high-performing teams; mentoring team members
Confident presenter and persuasive speaker. Ability to communicate effectively; excellent interpersonal skills.
Ability to manage multiple projects and meet deadlines. Strong follow up skills
Exercises professional judgement and demonstrates excellent problem resolution skills
Experience with Lean Six Sigma (LSS) tools and methodologies preferred.
Strong attention to details.
Extensive travel and frequent overnight travel
Education/Experience:
Bachelor’s or advanced degree in Nursing
Minimum of 5-years experience in nursing, 3 in hospice and 2 of which have been in a management role for a certified agency preferred
License/Certification:
Valid driver’s license and auto liability insurance coverage
Unencumbered and active RN license in state of residence required if RN.
Training/Equipment:
Computer skills to include solid knowledge of Microsoft Office Suite including Excel.
Experience using reporting tools and databases to review data in electronic systems.
Experience working with Homecare-Homebase preferred
We Offer Benefits for All Associates (Full-Time, Part-Time, and Per Diem)
Competitive Pay
401(k) with Company Match
Career Advancement Opportunities
National & Local Recognition Programs
Teammate Assistance Fund
Additional Full-Time Benefits
Medical, Dental, Vision Insurance
Mileage Reimbursement or Fleet Vehicle Program
Generous Paid Time Off + 7 Paid Holidays
Wellness Programs (Telemedicine, Diabetes Management, Joint & Spine Concierge Care)
Education Support & Tuition Assistance (ASN to BSN, BSN to MSN)
Free Continuing Education Units (CEUs)
Company-paid Life & Long-Term Disability Insurance
Voluntary Benefits (Pet, Critical Illness, Accident, LTC)
Legalese
This is a safety-sensitive position
Employee must meet minimum requirements to be eligible for benefits
Where applicable, employee must meet stage specific requirements
We are proud to be an EEO employer
We maintain a drug-free workplace
Location Gentiva Hospice
Our Company At Gentiva, it is our privilege to offer compassionate care in the comfort of wherever our patients call home. We are a national leader inhospice care, palliative care, home health care, and advanced illnessmanagement, with nearly 600 locations and thousands of dedicated clinicians across 38 states.
Our place is by the side of those who need us – from helping people recover from illness, injury, or surgery in the comfort of their homes to guiding patients and their families through the physical, emotional, and spiritual effects of a serious illness or terminal diagnosis.
Our nationwide reach is powered by a family of trusted brands that include:
Hospice care: Gentiva Hospice, Emerald Coast Hospice Care, Heartland Hospice, Hospice Plus, New Century Hospice, Regency SouthernCare, SouthernCare Hospice Services, SouthernCare New Beacon
Palliative care: Empatia Palliative Care, Emerald Coast Palliative Care
Home health care: Heartland Home Health
Advanced illness management: Illumia Health
With corporate headquarters in Atlanta, Georgia, and providers delivering care across the U.S., we are proud to offer rewarding careers in a collaborative environment where inspiring achievements are recognized – and kindness is celebrated.
#J-18808-Ljbffr
Director of Clinical Quality
reports to the Vice President of Clinical Quality. The Director of Clinical Quality is responsible for direct involvement, chart reviews, IDG attendance and oversight of corrections needed. This role evaluates needs in the individual branch and establishes a plan to implement changes and overall improvement of documentation. This role helps develop a process of accountability to ensure improvement of overall quality. The Director of Clinical Quality will develop, when applicable, and direct the implementation of corrective action plans in branches as a result of unfavorable internal survey or external conditional survey outcomes.
Essential Functions of Position
Upon initiation of a CMS audit which may include Targeted Probe and Educate, UPIC,SMRC and/or any other audit activity, theDirector of Clinical Qualityalong with the VP of Clinical Quality will analyze the office risk level and develop an action plan. This will include but not limited to education, audit initiation, interdisciplinary group review, calls to assist virtually and/or possible on-site visits.
On-going assessment of the branch will be provided on a regular basis and weekly reports to the VP of Clinical Quality will be provided to analyze outcomes and possible changes in plan.
Aids with claim denials and in the resolution of claims.
Collaboration with the Director of Clinical Operations and Vice President of Clinical Operations would be maintained to ensure coordination is maintained and delineate roles and responsibilities related to support and education actions.
Ensures compliance with local, state and federal regulations and accreditation standards. Provides support, direction and feedback to staff during the clinical compliance process. May delegate responsibilities to ensure follow-up to resolution of each action item identified.
Proactively assesses office performance and implements changes to prevent noncompliance. Communicates with up line manager, Chief Clinical Officer, Chief Compliance Officer, legal department, Utilization Management and other corporate resources as appropriate to address/resolve issues.
May work as support or back up to a Director of Clinical Operations at times when increased survey response is needed. This role would be a resource to help manage and contribute when appropriate.
Direct and monitor resolution of identified deficiencies in conditional surveys.
Support offices with quality measures in all areas which may include but not limited to claim denials, quality metrics, quality reviews and quality care.
About You Specialized Knowledge/Skills:
Extensive knowledge in the areas of documentation, and the interpretation and application of regulations and performance improvement standards required.
Must be knowledgeable of federal, state, and local regulations, as well as federal guidelines for hospice services. Knowledgeable in OSHA regulations.
Experience building and leading high-performing teams; mentoring team members
Confident presenter and persuasive speaker. Ability to communicate effectively; excellent interpersonal skills.
Ability to manage multiple projects and meet deadlines. Strong follow up skills
Exercises professional judgement and demonstrates excellent problem resolution skills
Experience with Lean Six Sigma (LSS) tools and methodologies preferred.
Strong attention to details.
Extensive travel and frequent overnight travel
Education/Experience:
Bachelor’s or advanced degree in Nursing
Minimum of 5-years experience in nursing, 3 in hospice and 2 of which have been in a management role for a certified agency preferred
License/Certification:
Valid driver’s license and auto liability insurance coverage
Unencumbered and active RN license in state of residence required if RN.
Training/Equipment:
Computer skills to include solid knowledge of Microsoft Office Suite including Excel.
Experience using reporting tools and databases to review data in electronic systems.
Experience working with Homecare-Homebase preferred
We Offer Benefits for All Associates (Full-Time, Part-Time, and Per Diem)
Competitive Pay
401(k) with Company Match
Career Advancement Opportunities
National & Local Recognition Programs
Teammate Assistance Fund
Additional Full-Time Benefits
Medical, Dental, Vision Insurance
Mileage Reimbursement or Fleet Vehicle Program
Generous Paid Time Off + 7 Paid Holidays
Wellness Programs (Telemedicine, Diabetes Management, Joint & Spine Concierge Care)
Education Support & Tuition Assistance (ASN to BSN, BSN to MSN)
Free Continuing Education Units (CEUs)
Company-paid Life & Long-Term Disability Insurance
Voluntary Benefits (Pet, Critical Illness, Accident, LTC)
Legalese
This is a safety-sensitive position
Employee must meet minimum requirements to be eligible for benefits
Where applicable, employee must meet stage specific requirements
We are proud to be an EEO employer
We maintain a drug-free workplace
Location Gentiva Hospice
Our Company At Gentiva, it is our privilege to offer compassionate care in the comfort of wherever our patients call home. We are a national leader inhospice care, palliative care, home health care, and advanced illnessmanagement, with nearly 600 locations and thousands of dedicated clinicians across 38 states.
Our place is by the side of those who need us – from helping people recover from illness, injury, or surgery in the comfort of their homes to guiding patients and their families through the physical, emotional, and spiritual effects of a serious illness or terminal diagnosis.
Our nationwide reach is powered by a family of trusted brands that include:
Hospice care: Gentiva Hospice, Emerald Coast Hospice Care, Heartland Hospice, Hospice Plus, New Century Hospice, Regency SouthernCare, SouthernCare Hospice Services, SouthernCare New Beacon
Palliative care: Empatia Palliative Care, Emerald Coast Palliative Care
Home health care: Heartland Home Health
Advanced illness management: Illumia Health
With corporate headquarters in Atlanta, Georgia, and providers delivering care across the U.S., we are proud to offer rewarding careers in a collaborative environment where inspiring achievements are recognized – and kindness is celebrated.
#J-18808-Ljbffr