Quality Assurance-RN / BSN-Home Health

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke HomeCare & Hospice

Pursue your passion for caring with Duke HomeCare & Hospice, which offers hospice, home health, and infusion services across the region, as well as serves as the home forthe Duke Caregiver Support Program. Team members work closely with a patient's physician to provide comprehensive, individualized care in the comfort of their home or at our inpatient hospice facility in Durham, NC.

We have a very cohesive team that works very closely together to ensure the highest quality assessments.

Shift :   8 : 00AM-5 : 00PM M-F

Location : Remote work with an occasional need to be in the office for teaching, etc.

General Description of the Job Class :

The Quality Assurance Analyst is responsible for performing professional administrative duties related to auditing, assessing, training and evaluating performance improvement and regulatory compliance activities of Duke HomeCare & Hospice (DHCH). In collaboration with the Director and with senior leadership, identifies, plans and executes activities, as well as designs / delivers staff education, to promote patient safety, clinical documentation, performance improvement initiatives and to ensure compliance according to regulatory statues, policies and procedures.

Duties and Responsibilities of this Level :

• Serves as liaison / resource to home care staff related to care / utilization.
• Conducts or arranges for educational opportunities for all home care staff related to clinical case management utilizing current managed care terminology and standards of practice to ensure the agency has a working knowledge and understanding of serving as a participating managed care provider, helps the staff to understand the paradigm shift and the resultant process change required to care for home care patients and communicate such under a managed care mindset.
• Approves plan of care after input from clinical staff. Plan of care approval to include appropriate discipline use, appropriate number of visits, and appropriate visits / plan goals. Innovative in determining alternative ways to provide health care services for clients.
• Coordinates and oversees the coordination of interdisciplinary Patient Care Conferences for homehealth patients to :

Specific Duties to this Service Line-DHCH

Coordinate utilization management, and ensure that episode management is efficient and meaningful.

Recommend to and / or participate with DHCH leadership in development of annual performance improvement, quality assurance and regulatory compliance strategic plans for assigned programs of DHCH.

Participate in Continuous Quality Improvement activities; identifies trends in utilization management which need addressing; submits data released to managed care and utilization management to quality assurance / improvement team indicating trends and recommendation for improvement.

Required Qualifications at this Level :

Education :

Experience :

Minimum of 2 years home care experience with at minimum 1 year experience related to performance improvement, quality assurance or regulatory affairs.

Oasis experience Required

Degrees, Licensures, Certifications :

Must have current or compact RN licensure in the state of North Carolina or Compact license from participating compact state.

Oasis and coding certification preferred

BLS required, but may be renewed during orientation.

Knowledge, Skills, and Abilities :

Working knowledge of Medicare and Medicaid regulations, JC and DHSR standards, and ICD-10 Coding. Maintains confidentiality of employee and patient information. Promotes quality, comprehensive services through a team approach. Excellent interpersonal communication and organizational skills required.

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions :

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and / or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.