Gentiva · 12 hours ago
Director Clinical Quality - East Region
Atlanta, GA
Full-time
Hybrid
Lead/Staff, Director/Executive
5+ years expGentiva Hospice is seeking a Director of Clinical Quality to support regional operations in the East Region. This role involves providing leadership, overseeing clinical compliance, and implementing corrective action plans to improve overall quality and documentation in hospice services.
BiotechnologyHealth Care
Responsibilities
Upon initiation of a CMS audit which may include Targeted Probe and Educate, UPIC,SMRC and/or any other audit activity, the Director of Clinical Quality along with the VP of Clinical Quality will analyze the office risk level and develop an action plan. This will include but not limited to education, audit initiation, interdisciplinary group review, calls to assist virtually and/or possible on-site visits
On-going assessment of the branch will be provided on a regular basis and weekly reports to the VP of Clinical Quality will be provided to analyze outcomes and possible changes in plan
Aids with claim denials and in the resolution of claims
Collaboration with the Director of Clinical Operations and Vice President of Clinical Operations would be maintained to ensure coordination is maintained and delineate roles and responsibilities related to support and education actions
Ensures compliance with local, state and federal regulations and accreditation standards. Provides support, direction and feedback to staff during the clinical compliance process. May delegate responsibilities to ensure follow-up to resolution of each action item identified
Proactively assesses office performance and implements changes to prevent noncompliance. Communicates with up line manager, Chief Clinical Officer, Chief Compliance Officer, legal department, Utilization Management and other corporate resources as appropriate to address/resolve issues
May work as support or back up to a Director of Clinical Operations at times when increased survey response is needed. This role would be a resource to help manage and contribute when appropriate
Direct and monitor resolution of identified deficiencies in conditional surveys
Support offices with quality measures in all areas which may include but not limited to claim denials, quality metrics, quality reviews and quality care
Qualification
Required
Extensive knowledge in the areas of documentation, and the interpretation and application of regulations and performance improvement standards required
Must be knowledgeable of federal, state, and local regulations, as well as federal guidelines for hospice services. Knowledgeable in OSHA regulations
Experience building and leading high-performing teams; mentoring team members
Confident presenter and persuasive speaker. Ability to communicate effectively; excellent interpersonal skills
Ability to manage multiple projects and meet deadlines. Strong follow up skills
Exercises professional judgement and demonstrates excellent problem resolution skills
Strong attention to details
Extensive travel and frequent overnight travel
Bachelor's or advanced degree in Nursing
Minimum of 5-years experience in nursing, 3 in hospice and 2 of which have been in a management role for a certified agency
Valid driver's license and auto liability insurance coverage
Unencumbered and active RN license in state of residence required if RN
Computer skills to include solid knowledge of Microsoft Office Suite including Excel
Experience using reporting tools and databases to review data in electronic systems
Preferred
Experience with Lean Six Sigma (LSS) tools and methodologies preferred
Experience working with Homecare-Homebase preferred
Benefits
401(k) with Company Match
Career Advancement Opportunities
National & Local Recognition Programs
Teammate Assistance Fund
Medical, Dental, Vision Insurance
Mileage Reimbursement or Fleet Vehicle Program
Generous Paid Time Off + 7 Paid Holidays
Wellness Programs (Telemedicine, Diabetes Management, Joint & Spine Concierge Care)
Education Support & Tuition Assistance (ASN to BSN, BSN to MSN)
Free Continuing Education Units (CEUs)
Company-paid Life & Long-Term Disability Insurance
Voluntary Benefits (Pet, Critical Illness, Accident, LTC)
Company
Gentiva
At Gentiva, it is our privilege to offer compassionate care that’s close to home – and close to the heart.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
unknown2014-10-09Acquired
2000-02-18IPO
Leadership Team
Nick Stengle
EVP & Chief Operating Officer, Gentiva (formerly Kindred at Home)
Dean Johnson, NACD.DC
Chief Commercial Officer, Executive Vice President of Sales and Marketing
Recent News
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