Quality Improvement Coordinator – AdventHealth Hospice

All the benefits and perks you need for you and your family:

• Benefits from Day One
• Paid Days Off from Day One
• Career Development
• Whole Person Wellbeing Resources
• Mental Health Resources and Support

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.

Schedule: Full Time

Shift : Day Shift

Location: Remote but training and meetings are held at the Altamonte Springs Hospice location.

The role you’ll contribute:

The Regulatory Response and Quality Improvement Coordinator is responsible for coordinating all activities related to processing requests for clinical records from regulatory agencies including, but not limited to, Additional Development Requests (ADRs), Recovery Audit Contractor (RAC) requests, Quality Improvement Organization (QIO) requests and Medicaid requests. This position is responsible for identifying performance improvement (PI) opportunities and for interdepartmental coordination of PI activities. The Regulatory Response and Quality Improvement Coordinator will participate in organizational regulatory response activities including writing/revising policies and procedures, developing operational procedures, and developing and presenting educational materials.

The value you’ll bring to the team:

• Coordinates all phases of record request processing including, but not limited to Additional Development requests (ADRs), Recovery Audit Contractor (RAC) requests and Medicaid audits (55%) * 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 assure that adequate staff resources are available for timely audit and processing activities; establishes needs and communicates these needs to department managers or directors. * Prioritizes record processing to assure that 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 as required. * Coordinates all communications with regulatory agencies such as Palmetto GBA or the Agency for Health care Administration (AHCA.) * Identifies employee educational needs related to regulatory scrutiny. * Partners with the Education Department to develop and provide education related to regulatory scrutiny.

The expertise and experiences you’ll need to succeed:

Minimum qualifications:

• Bachelor's Degree 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.
• 5+ year experience in the field of nursing is required. A minimum of 1 year of hospice experience is required.
• Active American Heart Association BLS.
• Valid in state Driver’s License with current car insurance
• Registered Nurse – State Licensure and/or Compact State Licensure In Florida

Preferred qualifications:

• Experience related to performance improvement, quality assurance is preferred, Hospice and/or home health care management experience.
• Certified Hospice And Palliative Nurse