Quality Safety Clinician

Description Job Schedule: Full Time Standard Hours: 40 Job Shift: Shift 1 Shift Details: Hartford HealthCare at Home is looking for a Quality Safety Clinician to manage the review of clinical documentation and assists in the training of clinical staff to ensure accurate reimbursement, regulatory compliance and the delivery of outcome-based, cost effective care. Job Duties: Facilitates record audits and process of care investigations, trends outcome data (satisfaction, utilization and clinical), develops and implements plans of action to ensure quality improvement, reimbursement and regulatory compliance. Reviews, calculates, and analyzes identified data processed by other team members as it relates to clinical documentation and quality of care. When indicated, reviews and processes certification/recertification and resumption of care orders ensuring accurate documentation and the development of an accurate plan of care with appropriate visit patterns and disciplines. Identifies areas for process improvement based on quality assurance and outcome studies results, and internal and external record review Collaborates with clinical supervisors and other case managers to identify agency trends based on the review of documentation and to develop and implement plans to address trends. Provides staff guidance in making clinical and case management decisions that are cost effective and focused on clinical outcomes and operational performance indicators. Conducts education and training sessions related to utilization, reimbursement and regulatory compliance. Participates in post payment reviews, compliance and claim audits, and assists with record reviews, audits and appeals as needed. Participates in quality assurance audits, committees & projects as needed. Demonstrates the ability to research regulations and legal requirements on reimbursement issues and to train staff appropriately. Demonstrates the ability to work well with others and to educate clearly and concisely. Maintains a flexible schedule to meet the needs of the agency. Qualifications Qualifications - External Registered Nurse with a license to practice in the State of Connecticut Graduate of an Associates degree or diploma program in Nursing; graduate of NLN-approved BSN program, preferred Three years clinical homecare experience. Managed care or case management experience required. Familiar with OASIS, home care regulations. Computer literate