Job Description
Job Description – Hospice Clinical Consultant
Overview of Responsibilities : The essential responsibilities of this role are:
Responsible and accountable to
- Assist clients in achieving hospice regulatory compliance.
- Establish and maintain standards of high quality and customer service in compliance with federal and state regulations and guidelines.
- Implement and evaluate goals and objectives for Hospice services that meet and promote the standards of quality and contribute to the organization regulatory and compliance standards being met.
- Support continuous improvement efforts by monitoring client performance metrics and providing ongoing recommendations.
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Duties and Responsibilities: - Reviews/audits clinical documentation to ensure all federal and state guidelines are met.
- Identifies trends with clinical documentation to assist with process improvement.
- Conduct comprehensive analysis of client processes and workflows, identifying opportunities for improvement and recommending solutions.
- Analyze documentation for hospice medical necessity and billing compliance.
- Plans, prioritizes, organizes and completes work to meet established objective within each assignment.
- Maintains effective and efficient ongoing communication with management, reporting all clinical aspects of concern, regulatory compliance issues, recommendations for improvement or other areas impacting the contracted Hospice Agency’s performance.
- Communicates with assigned clients on a consistent basis for services needs and education if indicated.
- Work with the Hospice Director and COO to facilitate resolution to client questions, concerns or issues.
- Utilizes clinical knowledge in assessing clinical documentation for best practice initiatives.
- Attends/participates in ongoing learning and education of industry changes that impact Hospice clinical services provided by SMART Healthcare Compliance Resources.
- Ensure s quality of Hospice services meet CMS standards and audit s consultants ongoing and provide the most updated education.
- Participate s in potential client meetings, discussions and follow-up as needed.
- Maintains confidentiality of patient and agency information, adhering to HIPAA guidelines.
- Participates and presents education, mentoring or agency education sessions to enhance knowledge base of internal or client staff as directed.
- Adheres to federal/state guidelines, rules and regulations, statutes, and laws .
- Participates in clinical consulting projects that may include, survey prep, Federal/state Plan of correction, due diligence projects, agency documentation assessments, education/presentations, client assistance to prep for medical review audits, claim appeals and other clinical consulting.
Qualifications: Licenses & Certifications : Hospice Nursing clinical background required; BSN/MSN preferred.
Rationalization Skills: Employee demonstrates proven ability to manage assignments from remote location. Capable of functioning with limited supervision. Ensures quality standards, productivity, accuracy, and timely work performed. Demonstrates knowledge and adherence to federal/state guidelines, rules and regulations, statutes, and laws. Exhibits financial knowledge, management, and integrity skills.
Education/Experience: Education : RN required ; bachelor’s degree or higher with formal Hospice clinical background;
Experience : Minimum of 5 years hospice, operational, regional and regulatory/compliance hands-on experience
Physical Demands: - Occasionally (up to 30%) – Standing, Bending, Squatting, Kneeling, Twisting, lifting to 50 lbs., Carrying up to 50 lbs.
- Frequently (31-60%) - walking
- Continuously (61 – 100%) - Sitting.
- Position may require periodic travel to conduct onsite work, and occasional overnight travel is needed.
- Visual, Hearing and Health Requirements – must be able to see a computer screen for long periods of time with corrective eyewear. Must be able to hear clearly with assistance and verbalize clearly.
Technology: Must have exceptional understanding of home health and hospice EMR software databases. Additionally, must have expertise with Microsoft Office products with a focus on Excel workbooks, Word, and Power Point.
Job Type: Full-time
Job Tags
Full time, Remote job, Night shift,