Performance Improvement Clinical Specialist

Reporting to a Corporate Director of Clinical Resources, this position is responsible for planning, coordinating and facilitating PI activities to improve clinical documentation and outcomes.  This initiative is going to be implemented company-wide and 50 PI Improvement Specialists will be hired.  This is a home-based position.  There will be 50% travel which will include overnight stays and the individual will be responsible for a geographic region.  It is expected that this person will be in the field 4 out of five weekdays. 

JOB DUTIES/KNOWLEDGE
1. Participate in/conduct PI activities to include, but not limited to:  utilization review, adverse events, outcome measures, falls, etc.

2. Facilitate Quarterly Performance Improvement multi-disciplinary team meetings.

3. Provide quality education and guidance to clinicians and agency leadership related to PI trends.

4. Input audit activities into appropriate database.

5. Analyze data and identify trends for use in optimizing compliance and educational strategies.

6. Review medical records utilizing appropriate tools requested for ADRs requested by FI/ MAC and by Recovery Audit Contractors.

7. Assure PI Audits and activities are completed in a timely manner.

8. Serve as a knowledge resource to assigned stakeholders.

9. Interact with Corporate Director of Clinical Resources on understanding of regulations/ best practices.

10. Act as a mentor and coach to managers and staff to drive continuous improvement.

11. Plan, coordinate and facilitate PI activities to improve clinical documentation and outcomes.

1. Current, unencumbered license to practice as a Registered Nurse.

2. Five (5+) years of Home Care experience.
3.  Ability to travel at least 50% locally and overnight stays

Strong knowledge of Conditions of Participation for Home Care and state regulatory bodies.

4. Requires knowledge of updated coding compliance guidelines, coding clinic references and CMS regulations.

5. Knowledge of care delivery documentation systems and related medical record documents.
6. Successful certification in OASIS and HCS-D coding within first 9 months of tenure in position.
7. Ability to work well independently and on a team.

8. Must have excellent oral and communication skills and be able to develop a positive working relationship with assigned stakeholders.

9. Proficient in computer skills (Excel, Microsoft, Office Applications).

10. Ability to present information effectively.