Regional QA Consultant

PACS Group
  • Kentucky
    4 days ago

    Job Description

    ential Duties
    1. Develop, implement, educate and monitor clinical programs that are intended to meet Professional
    Nursing Standard of Care and Nursing Standard of Practice per the applicable State Board of Nursing 
    and the American Nurses Association.
    2. Advise and support facilities in their efforts to comply with State and Federal Survey Regulations for
    Medicare and Medicaid Licensure and Certification, with special focus on Infection Prevention, 
    Control & Immunization.
    3. Assist facilities in response to endemic, epidemic, & pandemic disease outbreaks.
    4. Assist the Administrator and/or DON in writing plan of corrections (POC) and Allegation of
    Compliance (AOC) for any state and federal survey deficiencies cited. Review POC and AOC
    documents prior to submission.
    5. Monitor facilities compliance with POC’s submitted to State Health Department (HD) for recertification 
    of Medicare and Medicaid License.
    6. Provide oversight for reportable events that are submitted to HD which includes: reviewing and 
    approving reportable documents sent to HD and assisting facility in correction of issues identified.
    7. Provide training to facility Administration and/or staff as needed to help them meet Professional Nursing 
    Standard of Care and Nursing Standard of Practice per the applicable State Board of Nursing and the
    American Nurses Association; and State and Federal Survey Regulations for Medicare and Medicaid
    Licensure Certification.
    8. Assist Administrator with hiring, training and disciplinary actions for the Director of Nursing (DON).
    9. Conduct monthly Regional DON meetings for clinical program training and DON development.
    10. Assist facilities with their clinical, MDS, dietary, social services and regulatory policies and related 
    education.
    11. Assist DON in determining appropriate staffing structure and nursing PPD.
    12. Conduct visits to the facility to assess and train clinical staff. Create action plans as needed to facilitate 
    growth and development.
    13. Attend regional meetings and give clinical insight as requested by the RDO.
    14. Provide oversight and direction to the MDS department.
    15. Conduct Regional monthly MDS meetings for training and CMI development. Monitor and assist as 
    needed, RAC audits received from Insurance, State or CMS.
    16. Develop Regional tracking and trending reports for clinical metrics regarding CMS 5-star rating. Assist 
    facilities in improving 5-star rating in all categories.
    17. Assist facilities in their clinical risk management efforts.
    18. Assist facility defense attorneys as needed with lawsuits, depositions, reports and document production 

    as requested.
    19. Review record requests for appropriate documents for release.

    Requirements and Experience

    Required - Bachelor’s Degree in Nursing (BSN) or equivalent 
    Accredited Nursing Program Degree
    Master’s Degree in Nursing preferred
    20+ years of Clinical and Management experience preferred.
    Preferred experience: MDS certified, Legal Nurse Consultant or 
    Risk Management experience; previous Regional or Corporate Nurse 
    experience; experience with CMS/OIG surveys including Jeopardy 
    citations. PCC knowledge

    We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other legally protected status.

    Numbers & Facts

    LocationKentucky

    Skills

    • Administrative Skillsunmatched
    • Certified Legal Nurse Consultant (CLNC)unmatched
    • Clinical Facilitiesunmatched
    • Clinical Monitoringunmatched
    • Community and Social Servicesunmatched
    • Consultingunmatched
    • Content Management Systems (CMS)unmatched
    • Director of Nursing (DON)unmatched
    • Disciplinary Actionunmatched
    • Diseaseunmatched
    • Federal Laws and Regulationsunmatched
    • Insuranceunmatched
    • Litigationunmatched
    • Medicaidunmatched
    • Medicareunmatched
    • Metricsunmatched
    • Microsoft Remote Data Objects (RDO)unmatched
    • Nursingunmatched
    • Nursing Credentialsunmatched
    • Quality Assuranceunmatched
    • Regulationsunmatched
    • Risk Managementunmatched
    • Social Workunmatched
    • Staff Trainingunmatched
    • State Laws and Regulationsunmatched
    • Training/Teachingunmatched
    • Trend Analysisunmatched

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