QA/PI Utilization Coordinator AdventHealth Home Care
Location: Orlando, Florida
Internal Number: 22024563
Performance Improvement Coordinator AdventHealth Home Health
All the benefits and perks you need for you and your family:
Commitment to whole-person care, giving you the opportunity to help heal people in mind body and spirit.
Fulfilling work with people who treat you like family.
Excellent benefits, market-driven wages and career development opportunities.
Recognized for the seventh year in a row as a recipient of the Gallup Great Workplace Award as part of the AdventHealth network.
Opportunities for advancement as we expand our network across the nation.
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: Full Time
Shift: Monday to Friday 8am to 5pm, 1 weekend
Location: 602 Courtland St., Suite 310, Orlando, Florida 32804
The role you’ll contribute:
The Performance Improvement (PI) Coordinator is responsible for implementing the performance improvement program and related functions for home health. Related functions include but are not limited to performance of medical record review, utilization management, patient safety, compliance program, orientation program, ongoing education, competency and staff development as well as addressing bill hold items related to the medical record review and quality process as assigned.
The value you’ll bring to the team:
Implements performance improvement and quality activities to ensure compliance with federal/state home care regulations. Includes collection and use of comparative data, performance of specified audits and utilization management activities.
Serves as a resource to staff regarding agency operation and regulatory agency/intermediary requirements
Optimizes the smooth transition of care from referral source to home.
Fields initial admission calls from clinician in patient home to ensure admission criteria/payer eligibility is met and patient is involved in establishing the care plan.
Works with admitting clinician to establish initial care plan for all disciplines following utilization guidelines based on findings from the initial patient assessment.
Performs review of documentation and plan of care to ensure congruency with primary focus of care, care plan, physician face to face encounter and reason for homecare and utilization of appropriate disciplines.
Communicates effectively with all team members to ensure care is appropriately set up and managed for the patient.
Assists in the development and implementation of Performance Improvement Projects (PIPS) and collaborates with team to make improvements in metrics related to safety and regulatory compliance.
Participates/completes assigned audits by collecting and reporting data. Identifies patterns and trends over time that are used to improve areas related to the audit.
Ensures that patient outcomes are monitored and improved through appropriate safety/preventive measures.
Assists with analysis of potentially avoidable events and in evaluating outcome for opportunities that may include process design, staff education, assessment and documentation
Performs review and correction (or directs correction) with items related to bill holds and unbilled reports and assists with coaching staff to meet requirements
Maintains membership of and participates in applicable home care-related and professional organizations.
The expertise and experiences you’ll need to succeed:
Associate degree in nursing.
Minimum 3 years home health experience as a Registered Nurse
A clear/active Florida Registered Nurse (RN) license.
Basic Life Support certification
Maintain a current, valid Florida Driver's License in good standing with a safe driving record and a reliable vehicle.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.