Quality Reporting Coord - 40 hrs/wk, flex schedule, Mon - Fri

Job Title:  Quality Reporting Coordinator                                                             
Job Location:  Lincoln
Immediate Supervisor: Quality Risk Management Manager
Status: Non-Exempt                         


JOB OVERVIEW

Responsible for ensuring compliance with all state and federal requirements related to the Inpatient Rehabilitation Facility (IRF) and Long Term Care Hospital (LTCH) CMS Quality Reporting Program; oversees the accurate and timely completion/transmission of the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) and LTCH CARES tool; and will use a collaborative process with all departments and persons responsible for the data elements. 
Oversees all aspects of data collection, ensures the presence of supporting documentation, and provides staff education to ensure compliance with internal policy and external regulatory requirements, including applicable CARF International standards and CMS guidelines. Identify trends and opportunities for improvement in clinical documentation related to IRF-PAI and LTCH CARES tool.  Collaborate with the Medical Record (HIM) Coding Staff, Patient Financial Services Staff and any team members making entries into the medical record.
Gather and analyze quality and credentialing data. In coordination with the Credentialing Manager and Quality and Risk Manager strategizes for improvements related to identified initiatives. 

ESSENTIAL FUNCTIONS

• Maintains current knowledge of regulations for Inpatient Rehabilitation facilities (IRF) and specialty hospitals (LTCH) related to CMS Quality Reporting and of the IMPACT Act. Communicates changes in regulation to supervisor.
• Uses the EMR and other resources to compile and complete the IRF-PAI and CARE tool.
• Validates specific data elements to ensure accurate completion of the IRF-PAI and CARE tool.
• In coordination with manager reviews content of information delivered at new employee orientation related to ADL/Sunrise documentation that is used to complete IRF-PAI and CARE tool. Mentors all users as necessary throughout the data collection process.
• Works collaboratively with licensed practitioners to assure both accurate and complete documentation.
• Collaborates with hospital business system leaders in the development and interpretation of policies and procedures when faced with changes in applicable regulations.
• Assures that the IRF-PAI or CARE tool is electronically submitted to CMS as required by law.
• Monitors the course of patient care to assure changes are accurately reflected throughout the documentation and the required transmissions.
• Has access to confidential patient information and maintains confidentiality of all information.
• Collects, compiles and reports Ongoing Professional Practice Evaluation (OPPE) data and Focused Professional Practice Evaluation (FPPE) data and prepares reports for review as evidence of competency in privileges granted.
• Communicates with coding professionals and licensed practitioners to clarify and determine etiologic diagnosis, co-morbid conditions, and any complications.
• Works with Madonna Clinical Analysts and ITS staff to assure the optimal use of the electronic medical record for data collection elements.
• Collaborates with manager to remain proficient in the definition of infections as described by the National Healthcare Safety Network.
• May participate in team meetings and reviews documentation concurrently throughout the stay to ensure accurate documentation. Trends and reports Medicare IRF-PAI results, including monitoring of the CARE tool assessments as assigned.
• Submits reports based on facility needs.
• Provides back up coverage to Employee Health Services and other quality reporting coordinator.
• Proficient with Microsoft Office and other applications required to complete essential job duties.
  
  
  QUALIFICATIONS
• Must be a Registered Nurse with a minimum of 2 yearâ??s experience, one within a post-acute setting.
• IRF-PAI and/or CARE tool experience preferred.  Must be self-motivated and demonstrate excellent organizational skills and problem solving abilities
• Must have excellent communication and organization skills.