POSITION SUMMARY: Pikes Peak Hospice & Palliative Care has an immediate opening for a Director of Quality, Compliance & Education. RN license and hospice experience preferred.
This position establishes and maintains patients’ medical documentation and records according to industry standards, ensuring compliance with federal and state regulations. Reviews, recommends and writes Health Information Management (HIM) policies and procedures ensuring compliance with home health and hospice regulations. Fulfills requests for documentation from the Fiscal Intermediary (FI), ensures appropriate ICD-10 coding for patients’ medical records. Serves on committees as related to HIM, performance improvement and regulatory issues.
KEY REPORTING RELATIONSHIPS: Reports to VP of Quality Compliance and Education
ESSENTIAL DUTIES: Provides direction, support, and collaboration while trouble-shooting health information systems, procedural problems, transcription and data flow. Works with various agency teams and managers to proactively anticipate and support their health information, regulatory, and performance improvement needs.
Manages and provides directional leadership to Health Information and Quality and Education departments, ensuring current skill training, development, daily operations, budget adherence, assignment of duties, and performance improvement.
Participates in meetings, quality assurance and performance improvement initiatives (QAPI), clinical record and utilization reviews, and Forms Committee, as required.
Compiles data and provides statistical information and reports as requested by management and contract agencies. This includes agencies reviewing hospice records for audit or reimbursement purposes, such as Additional Development Requests (ADR’s) and Centers for Medicare & Medicaid Services (CMS) requirements.
Coordinates and implements new Health Insurance Portability and Accountability Act (HIPAA) requirements into health information processes and protocols, ensuring compliance to requirements.
Trains and audits patient documentation and ensures release of information in accordance with federal/state regulations, HIPAA and agency policy. Ensures timely storage, retrieval, destruction, and security of patient records.
Ensures appropriate and timely ICD-9 coding for patient records.
Develops, implements, and maintains health information policies and procedures.
Other duties and responsibilities as assigned.
CORE COMPETENCIES: Possesses knowledge of health care law, fraud, and abuse and Medicare/Medicaid reimbursement.
Demonstrates knowledge of federal/state regulations, Office of Inspector General (OIG) and hospice/home health compliance risk area, HIPAA, and other regulatory requirements.
Possesses basic computer application knowledge.
Communicates effectively between departments and with outside medical professionals. Possesses excellent written and verbal communication skills as well as analytical and problem-solving skills.
Empowers team through strong leadership skills, flexibility, attention to detail and timely and effective follow up.
Analyzes and reviews processes and documentation and provides statistical data and interpretations in timely manner.
Participates in continuing education and professional development.
POSITION QUALIFICATIONS: Minimum Education: Bachelor’s degree required, Master’s degree preferred. Registered Health Information Technology Certification (RHIT) preferred
Required License: Valid Colorado state driver’s license and proof of auto insurance. RN license preferred.
Internal Number: 1001
About Pikes Peak Hospice & Palliative Care
Pikes Peak Hospice & Palliative Care has been the community leader in hospice and palliative care for 39 years, founding the hospice movement in the Pikes Peak region in 1980. We are the only nonprofit, community-based hospice in El Paso County.
Every year, we help more than 2,000 patients and families navigate the challenges of a life-limiting illness with comfort, dignity and fulfillment. In a business like this, you don’t thrive for this long, nor serve as many patients as we have, without holding to a particular standard.
Ours is simple: We believe that hospice care is about living, and that every patient and family deserves consistent expert care and compassionate personal attention. Here are just a few things that set Pikes Peak Hospice & Palliative Care apart:
•Comprehensive team of hospice and palliative experts including our physicians, nurse practitioners, nurses and certified nursing assistants, counselors, chaplains, pharmacists and administrative professionals
•More than 300 trained volunteers supporting professional care teams
•Fast response and 24/7 access to care
•The only dedicated hospice inpatient care unit in El Paso County
•A comprehensive grief counseling program, including specialized care for children and teens