Quality Assurance Administrator - Gilchrist

Under general supervision, designs and carries out quality assurance programs with medical, nursing and ancillary staff.

Education:
High School or equivalent/Associates or Bachelor’s Degree preferred
Licensures/Certifications:
Not Applicable
Experience:
One-year healthcare experience required. Previous experience in a customer support role, EMR experience required, LTC experience a plus, Proficient in relevant computer applications.
Skills:
• Knowledge of healthcare regulatory agency standards for hospice
• Knowledge of medical terminology is preferred
• Skill in using basic computers and personal productivity applications
• Demonstrated ability to manage and generate reports in EPIC
• Ability to multi-task, set priorities, and manage time effectively
• Skill in written and oral communication
• Ability to effectively review, analyze and patient care paper work assuring compliance with regulatory and company standards

Principal Duties and Responsibilities:
• Conducts regulatory audits of patient charts currently on service.
• Generates daily admission reports to perform admission reviews. Includes thorough review of all documentation for both the initial and continued eligibility for hospice care including diagnosis, care planning, and visit notes related to the patient’s course of treatment.
• Print Plan of Care (POC) after review of all admission documentation to assure accuracy and consistency throughout the patient’s medical record. Responsible for communicating with physician offices and faxing POCs. Monitor the return of signed POCs via fax and mark in EPIC using the POC report.
• Review all Consent and Election of Benefit forms on all new Hospice Admissions and scan into EPIC.
• Audits completion of the initial Certificate of Terminal Illness, and ensures the CTI has two physician signatures within the regulatory time frame, including receipt of all appropriate MD signatures. Communicates by any means necessary such as phone, fax, mail and e-mail to ensure communication is established.
• Utilize and maintain the POC report in EPIC in daily work.
• Review all Hospice Item Set (HIS) and compare to nursing assessment, verify, and mark for Submission to CMS
• Monitor for trending issues within collected data related to documentation and compliance. Collaborate with IDT to communicate observations and discuss effective coaching strategies for teams or individuals related to documentation.
• Generates and electronically files appropriate patient related information for the medical record consistent with company policy and regulatory requirements (POCs and Consents)
• Review of Attending of Hospice Record (AOHR) listed on Consent forms and in Ancillary provider section in EPIC.
• Gathers data and information as directed. May use data to develop administrative and statistical reports.
• Responds to phone calls, e-mails, and mailings timely.
• Maintain compliance with all HIPAA standards and regulations.
• Maintain efficient time management to ensure compliance with all State and Federal requirements
• Maintain a current knowledge base of industry standards
• Provide educational sessions for documentation, policies and procedures, and expectations as needed, including orientation.

All roles must demonstrate GBMC Values:

Respect

I will treat everyone with courtesy. I will foster a healing environment.

• Treats others with fairness, kindness, and respect for personal dignity and privacy

• Listens and responds appropriately to others’ needs, feelings, and capabilities

Excellence

I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

• Meets and/or exceeds customer expectations
• Actively pursues learning and self-development
• Pays attention to detail; follows through

Accountability

I will be professional in the way I act, look and speak. I will take ownership to solve problems.

• Sets a positive, professional example for others
• Takes ownership of problems and does what is needed to solve them
• Appropriately plans and utilizes required resources for various job duties
• Reports to work regularly and on time

Teamwork

I will be engaged and collaborative. I will keep people informed.

• Works cooperatively and collaboratively with others for the success of the team
• Addresses and resolves conflict in a positive way
• Seeks out the ideas of others to reach the best solutions
• Acknowledges and celebrates the contribution of others

Ethical Behavior

I will always act with honesty and integrity. I will protect the patient.

• Demonstrates honesty, integrity and good judgment
• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

Results

I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

• Embraces change and improvement in the work environment
• Continuously seeks to improve the quality of products/services
• Displays flexibility in dealing with new situations or obstacles
• Achieves results on time by focusing on priorities and manages time efficiently

Pay Range

$20.75 - $35.12

Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.

COVID-19 Vaccination

All applicants must be fully vaccinated against Covid-19 or obtain a GBMC approved medical or religious exemption prior to starting employment at GBMC Healthcare, to include Gilchrist and GBMC Health Partners.

Equal Employment Opportunity

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.