Registered Nurse Quality Improvement- AdventHealth Hospice Care
Location Address: 480 W. Central Parkway, Altamonte Springs, FL 32714
Top Reasons to work at AdventHealth Hospice Care
AdventHealth Hospice Care is the only not-for-profit, faith-based, Hospice provider in the Greater Orlando Area
We are part of the largest healthcare system in the area, AdventHealth
For almost 30 years, we have provided compassionate care to patients and families during their time of need
We are a growing organization looking for special talent to come and grow with us
Besides offering world-class entertainment at the theme parks, the Central Florida area boasts many other entertainment options, such as state parks, nearby beaches, restaurants, performing arts, and professional sports
Full Time Day Shift
You Will Be Responsible For:
Coordinates all phases of record request processing including, but not limited to
Additional Development requests (ADRs), Recovery Audit Contractor (RAC)
requests and Medicaid audits
1.Develops and implements procedures and processes for record request management.
2. Instructs medical, clinical and administrative staff in record request audit and processing procedures
3.Coordinates with other departments to assure that adequate staff resources are available for timely audit and processing activities; establishes needs and communicates these needs to department managers or directors.
4.Prioritizes record processing to assure that submission deadlines are met.
5.Coordinates all levels of appeals processes for denied claims.
What You Will Need:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made when requested, to enable individuals with disabilities to perform the essential functions.
A. Education and Training: Bachelorâ™s Degree in Nursing, Health Care, or related field is required. An equivalent combination of education and experience may be substituted at the discretion of the Administrator.
B. Experience: A minimum of 5 years of experience in the field of nursing is required. A minimum of 1 year of hospice experience is required. Experience related to performance improvement, quality assurance is preferred, Hospice and/or home health care management experience is preferred.
C. Certificates and Licenses Required: A clear/active Florida Registered Nurse (RN) licensed is required, Certified Hospice and Palliative Nursing (CHPN) certification is preferred.
D. Knowledge and Abilities:
Knowledge of nursing skills in the performance of duties in compliance with the legal and ethical parameters established and based on the level of education and certification attained by the employee.
The Regulatory Response and Quality Improvement Coordinator is responsible for coordinating all activities related to processing requests for clinical records from regulatory agencies including, but not limited to, Additional Development Requests (ADRs), Recovery Audit Contractor (RAC) requests, Quality Improvement Organization (QIO) requests and Medicaid requests. This position is responsible for identifying performance improvement (PI) opportunities and for interdepartmental coordination of PI activities. The Regulatory Response and Quality Improvement Coordinator will participate in organizational regulatory response activities including writing/revising policies and procedures, developing operational procedures, and developing and presenting educational materials.
AdventHealth Greater Orlando (formerly Florida Hospital) is one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.