Kaiser Permanente Coordinator Quality Improvement & Compliance - Registered Nurse (1.0 FTE - Capitol Hill - RN) Seattle in Seattle, Washington

Collaborate in the design, implementation and maintenance of quality and regulatory activities for Home Health and Hospice. Leads, facilitates and mentors quality committees, individuals and teams to assure development of processes to achieve quality and compliance outcomes. Monitors and evaluates the complex and constantly changing compliance and regulatory environment, rules and trends to advise and interpret applicability to Home Health and Hospice. Audits results, identify opportunities for improvement and facilitates process improvement activities to assure compliance. Responsible for timely and accurate submission of CMS required assessments for both Home Health and Hospice.

Essential Responsibilities:

  • Audits clinical documentation and clinical processes, provides feedback to staff and managers and recommends training as needed. Identifies performance improvement opportunities based on needs identified through audits. Works with third party vendors for diagnosis coding accuracy and patient satisfaction surveys.

  • Regulatory Activities - Serve as agency point of contact for and coordinates activities with multiple regulatory agencies and contracted vendors, such as the Medicare Quality Improvement Organizations (QIO), CMS HH Value Based Purchasing, Hospice PEPPER reports, quality / patient satisfaction survey data vendors, and EMR software vendor regulatory panels. Coordinate requests for information and responses to regulatory agencies that have state and national authority over Home Health and Hospice. Participate in DOH surveys and investigations. Participate in regulatory forums to provide input and gather information. Responsible for creation, review, and timely submission of CMS required assessments and notifications for Home Health and Hospice. Partners with business office to assure billing and authorization processes are in compliance to maximize revenue and minimize risk. Communicate requirements to clinical staff for authorization and documentation.

  • Committee chair of the Quality Committee. Provide expertise and facilitates teams in the use of quality tool, processes, data collection and analysis. Directs the review of quality measures, assessing opportunity for performance improvement. Collects quality measures from various sources, analyses data and presents deficiencies and trends. Produces reports and dashboards for quality team and leaders. Leads root cause analysis discussion and development of improvement plan.

  • Develops, implements and maintains a process for evaluating and trending patient safety issues , unusual occurrences and internal complaints to identify trends and need for intervention. Develop infection surveillance activity, audit results and create report to infection control committee.

  • Cultivate a culture of increased compliance awareness and responsibility within Home Health and Hospice. Continuously monitor and conduct analysis of HH and HP regulations. Evaluate the impact of regulations for HH and HP in the complex and frequently changing regulatory environment. Analyze regulations, identify compliance risks and provide advice on implementing processes to comply with new or existing regulatory requirements. Participate in development and implementation of compliance related communication and training.

Basic Qualifications:

Experience

  • Minimum two (2) years of experience in quality management and improvement in a health care setting.

  • Minimum two (2) years of experience working with regulations and compliance in a health care setting.

  • Minimum five (5) years of experience in a health care setting.

Education

  • Bachelor's degree in nursing.

License, Certification, Registration

  • WA state RN License by date of hire/transfer.

Additional Requirements:

  • Knowledge in quality and process improvement methodologies such as LEAN.

  • Knowledge in home health and/or hospice operations and regulatory issues.

  • Effective oral and written communication skills.

  • Self directed with the ability to do independent problem solving and analysis.

  • Ability to work on multiple projects simultaneously and prioritize work to meet deadlines.

  • Demonstrates ability to facilitate groups and set direction to achieve goals.

Preferred Qualifications:

  • Experience in quality management and improvement in home health or hospice.

  • Two (2) years of experience working with regulations and compliance in home health or hospice.

  • Five (5) years of experience in home health or hospice.

  • Experience in developing training materials and provide training.

  • Master's degree in nursing or related field.

  • Participation in regulatory surveys.

COMPANY: KAISER

TITLE: Coordinator Quality Improvement & Compliance - Registered Nurse (1.0 FTE - Capitol Hill - RN) Seattle

LOCATION: Seattle, Washington

REQNUMBER: 688764

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.