QI/QM Nurse Specialist

About the role

Goal: The QI/QM Nurse Specialist will assist the facilities to improve the overall 5-Star Ratings with emphasis on the Quality Measures through ongoing education with the facility staff and monitoring the MDS process.

Duties

• Monitor the QM ratings for all facilities every month and develop a specific plan for improvement on any Quality Measure above the National percentage or over the 75th percentile with emphasis on the 4 Quality Measures that impact the QIPP program. The QM reports including the facility characteristics and the resident roster out of Simple LTC will be analyzed to determine the appropriate interventions for each facility.
• Educate the facilities on the Quality Measures on at least a quarterly basis at the Regional Meetings. Focus of the education will include managing the MDS process to enhance the QM’s and reimbursement related to the MDS. Education will be coordinated with the Reimbursement Specialist.
• Review the facility transmission reports through Simple LTC daily to:

• a. Evaluate the errors and assist the facility with correction, if appropriate;
• b. Educate the MDS Coordinator/DON related to the errors/issues;

• c.
• Assist with the corrections to the MDS based on the resident assessment to increase accuracy of the MDS, decrease triggers, and improve reimbursement; and d.
• Report to the RDO/RNC and VP of Operations at least monthly the results of the facility reviews.

• Provide focused training with the facilities who have difficulty managing the QM process, have a new MDS Coordinator or DON, or at the request of the administrative staff or corporate staff.
• Coordinate all training and education with the Reimbursement Specialist, RDO, RNC, and the VP of Operations.
• Provide QM analysis reports to the corporate team every month with an action plan for any facility above the national percentage or above the 75th percentile on any QM.
• Assist the RDO and RNC with the monthly clinical review related to the QM’s and QAPI.
• Develop training modules/presentations for all the QM’s based on “best practices” for ongoing training at the facility level.
• Attend on-going training associated with the MDS process, QM/QAPI, and the QIFF program.

Qualifications & Requirements

• Must have worked in long-term care, skilled nursing or a nursing home.
• RN preferred, but not necessary
• MDS experience a must

Additional Information

All your information will be kept confidential according to EEO guidelines.