Job Type: Regular

Time Type: Full time

Work Shift: Day (United States of America)

FLSA Status: Non-Exempt

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

32hpw, 7:30am- 4:00pm, Monday-Friday

Job Description:

POSITION SUMMARY: In accordance with Agency policy , supervises staff, establishes, maintains, and evaluates nursing standards of care and service for the Agency. Responsible for assisting with coordination of the QAPI program. Responsible for gathering all required information and chart audits for ADR’s and other audits from Regulatory bodies, Insurance companies, etc. Monitors and maintains compliance with regulatory changes that affect coding and reimbursement Manages projects and works with non-clinical and clinical staff to ensure successful outcomes. Ensures compliance with Joint Commission Standards.

Duties/Responsibilities:

• Supervises nursing staff and nursing practice consistent with Agency and professional standards and

policies.

• Ensures the orientation of new staff and, in collaboration with the Hospice Director, counsels and evaluates staff. Acts as a resource/mentor for patient care management for staff.

• Identifies education needs and participates in educational programs

• Participates in developing and maintaining staff competency program

• Communicates regularly with nursing staff, peers and immediate supervisor

• With Hospice Clinical Director, establishes the Annual Comprehensive QAPI Evaluation and Plan for the upcoming year.

• Monitors and evaluates QA Measures which include, but are not limited to, Patient Fall, Patient Infections, Adverse Events, Hospice Benchmark Data.

• Initiates the FMEA focusing on high volume, high risk processes of the agency.

• Leads the Infection Control Program, coordinates with the hospital and educates staff and patients/families.

• Develops and assesses the Hazard Vulnerability Analysis with the Clinical Director.

• Maintains/reviews the Emergency Response Plan.

• Review/evaluate QA data provided by Deyta (Healthcare First), FEHS, FEBS, Pepper and CMS as well as EMR chart audits

• Initiates and collaborates with staff on various Performance Improvement Projects

• Implements and Coordinates CMS Quality Reporting Program

• Audits charts periodically to assess for completeness and compliance with all Regulations and various clinical outcome measures.

• Promotes quality achievement and performance improvement throughout the organization.

• Ensures adherence to federal, state, and Agency regulations and policies.

• Participates in the Massachusetts Federation’s Hospice QAPI organization and collaborates with other MA Hospices in various projects.

• Supervises the regulatory compliance of the EMR and educates staff in an ongoing manner with all updates and changes.

• Ensures/supervises that documentation in all areas is correct, complete and compliant.

• Creates and prepares a variety of relevant reports and educates staff regarding documentation to facilitate data collection.

• Other responsibilities as directed.

• Assumes on-call responsibility as needed

Education/Experience Required:

• Current Massachusetts RN license

• BSN

• Minimum three years management experience in hospice, home care or health related setting

• Demonstrated experience in effective supervision and communication.

• Extensive knowledge of Quality Management, Staff Education Training in the use of Coding and external reporting sites.

Knowledge and Abilities:

• Comprehensive knowledge of documentation compliance

• Excellent written, oral and presentation skills

• Demonstrated leadership and customer service approach in hospice, homecare or related setting

• Working knowledge of hospice EMR, Microsoft Office, including Word and Excel

• Excellent verbal and written skills.

• Working knowledge of CMS regulations pertaining to Hospice/Home Care

• Knowledge of Agency philosophies, policies and programs.

• Extensive knowledge of Quality Management, Staff Education

• Exhibits excellent problem-solving skills and critical thinking.

• Current knowledge of relevant local, state and federal regulations governing hospice/home care.

• Thorough knowledge of methodologies of quality assurance and standards

• Excellent numerical skills and understanding of data analysis/statistical methods; great attention to detail and outcome-based approach.

• Excellent organizational and leadership abilities.

• Ability to manage projects and work as a liaison between clinical and non-clinical areas to reach successful outcomes.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) and COVID-19 as a condition of employment. Learn more (https://www.bilh.org/newsroom/bilh-to-require-covid-19-influenza-vaccines-for-all-clinicians-staff-by-oct-31) about this requirement.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled