Description:
ACHC is currently recruiting a personable and detail-oriented Clinical Review Specialist to perform the associated duties which support and accomplish the accreditation process for the community based programs to include Home Health & Hospice programs.
This person will be responsible for providing interpretation of ACHC standards with special emphasis on standards issued related to specific settings, professional disciplines, or accreditation and certification programs. This person will also be educating surveyors and customers alike on the accreditation services and associated standards of ACHC, as well as participating in the development and revision of standards and survey processes.
The ideal candidate will possess a passion for quality and promoting improvement, along with the ability to think outside the box to do so. S/he should also exhibit exceptional communication skills with a positive demeanor that contributes to favorable and meaningful interactions with a variety of key stakeholders.
RESPONSIBILITIES AND DUTIES:
- Review Summary of Findings (SOF) documentation submitted by Surveyors, ensuring accuracy.
- Complete the Company Review Form and present the findings of the survey to the Accreditation Review Committee.
- Participate as an active member of the Accreditation Review Committee.
- Review Plans of Correction (POCs) submitted by providers for accuracy and completeness.
- Complete and submit post-accreditation Medicare paperwork.
- Review Evidence as submitted by providers for accuracy and completeness.
- Document all reviews per ACHC protocols.
- Educate providers as needed to ensure POCs and Evidence comprehensively addresses deficiencies.
- Provide standards interpretation for customers and accreditation department staff for the community based programs which include Home Health, Hospice and Home Care
- Conduct surveys, including complaint and focus surveys ensuring compliance with ACHC Standards for Accreditation if needed.
- Provide support to Program Leads for daily operational processes.
- Review and recommend changes to department policies and work instructions to maintain the Quality Management System (QMS) and the integrity of departmental processes.
- Attends trade shows and workshops to promote all programs and services when needed. Prepares and conducts state and national presentations when needed.
QUALIFICATIONS AND SKILLS:
- Currently licensed Registered Nurse with a Home Health and Hospice background in quality or management, surveyor experience and knowledge of interpreting Medicare COPs and state licensure rules
- Five years of Home Health and Hospice experience that includes two years of quality assurance planning and implementation, management of a home health or hospice provider or experience that includes successfully becoming accredited.
- Experience working with computer systems with proficient use of database and other office system programs.
- Proficient in Microsoft Office applications
- Strong oral and written communication skills and presentation skills.
- Customer service experience
- Must be willing to travel (15-20%)