Essential Functions/Responsibilities:

Essential functions are the duties and responsibilities that are essential to the position (not a task list).  o not include if less than 5% of work time is spent on this duty.  Be specific without giving explicit instructions on how to perform the task.  Do not include duties that are to be performed in the future.  Duties should be action oriented and avoid vague or general statements. 

% of Time

(annually)

Reviews outcomes, process, and case mix reports for trends and opportunities for improvement.

·         Provides feedback to local leadership and CRT quality on clinical performance.

·         Leads and facilitates process improvement, process developments, and action plans.

·         Facilitates local quality and process improvement meetings.

·         Facilitates local process improvement teams using standard set of tools/resources.

·         Stands as a resource for accreditation, state and federal surveys.

·         Reviews all OASIS alerts, edits and inconsistencies and discusses any potential errors. 

o     Prepare monthly report and transition report to the clinical supervisor.

·         Provides feedback to Clinical Supervisors and Clinical Manager on clinical performance

         55%

Demonstrates initiative to improve quality and customer service by striving to exceed customer expectations.

·         Demonstrates the ability to meet the department work schedule.

·         Meets measures as determined and required for job productivity and performance improvement.

·         Behaves in a manner consistent with Mission, Vision, Values and Expectations for Excellence. 

·         Assists with maintenance compliance with state and federal regulations, applicable accreditation standards and risk management guidelines.

25%

Maintains compliance with Personnel policies and procedures. 

·         Performs other duties as requested by the Quality Review Supervisor to facilitate smooth and effective operations of the organization.

·         Completes communication tasks and activities in a timely manner. This would include, but is not limited to: responding to email, voicemail or telephone messages, promptly, accurately, and professionally; attending staff meetings as scheduled or viewing videotapes of those meetings; asking questions of team members and supervisors when needing clarification about various day-to-day issues or patient needs; and reviewing employee communication pieces, to stay aware of UnityPoint at Home programs and initiatives. 

·         Attends occasional after-hours meetings as required

10 %

Basic UPH Performance Criteria         

·         Demonstrates the UnityPoint Health Values and Standards of Behaviors as well as adheres to policies and procedures and safety guidelines.

·         Demonstrates ability to meet business needs of department with regular, reliable attendance.

·         Employee maintains current licenses and/or certifications required for the position.

·         Practices and reflects knowledge of HIPAA, TJC, DNV, OSHA and other federal/state regulatory agencies guiding healthcare.

·         Completes all annual education and competency requirements within the calendar year.

·         Is knowledgeable of hospital and department compliance requirements for federally funded healthcare programs (e.g. Medicare and Medicaid) regarding fraud, waste and abuse.  Brings any questions or concerns regarding compliance to the immediate attention of hospital administrative staff.  Takes appropriate action on concerns reported by department staff related to compliance.

10%

Disclaimer: This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that required of the employee.  Other duties, responsibilities and activities may change or be assigned at any time with or without notice.

Demonstration of UPH Values and Standards of Behaviors

Consistently demonstrates UnityPoint Health’s values in the performance of job duties and responsibilities

Foster Unity:

·         Leverage the skills and abilities of each person to enable great teams.

·         Collaborate across departments, facilities, business units and regions.

·         Seek to understand and are open to diverse thoughts and perspectives.

Own The Moment: 

·         Connect with each person treating them with courtesy, compassion, empathy and respect

·         Enthusiastically engage in our work.

·         Accountable for our individual actions and our team performance.

·         Responsible for solving problems regardless of the origin.

Champion Excellence:

·         Commit to the best outcomes and highest quality.

·         Have a relentless focus on exceeding expectations.

·         Believe in sharing our results, learning from our mistakes and celebrating our successes.

Seize Opportunities:

·         Embrace and promote innovation and transformation.

·         Create partnerships that improve care delivery in our communities.

·         Have the courage to challenge the status quo.

Minimum Requirements

Identify items that are minimally required to perform the essential functions of this position.

Preferred or Specialized

Not required to perform the essential functions of the position.

Education:

Graduate of an accredited nursing program.

Formal education and training in QAPI and utilization review

• Demonstrated success in leading and sustaining change through health care improvement initiatives, and change leadership using methodologies such as Six Sigma, Baldrige, Lean, Work-Out™, PDSA, and Adaptive Design.
• Demonstrated ability to successfully lead cross-functional teams to achieve sustainable results.

All staff are expected to participate in appropriate continuing education

Experience:

Three years nursing experience, preferably in community/home health, management or review

License(s)/Certification(s):

Current licensure in good standing as a Registered Nurse in the State of Illinois.

Must possess and maintain current OASIS Specialist-Clinical (COS-C) certification within on year of hire/start date.

Knowledge/Skills/Abilities:

• Demonstrated capability to handle multiple teams and tasks simultaneously and under strict deadlines.
• Demonstrated computer capabilities in retrieval and analysis of both operational and financial data.
• Meets all team deadlines and responsibilities, listens to others and values opinions, helps team leader to meet goals, welcomes newcomers and promotes a team atmosphere.
• Breaks down problems into smaller components, understands underlying issues, can simplify and process complex issues, understands the difference between critical details and unimportant facts; challenges the status quo, takes risks, and solves problems creatively.
• Ability to skillfully draw out information, opinions and ideas in a group setting. Handles difficult people and ensures everyone has an opportunity to be heard by managing distractions and interruptions.
• Excellent presentation and training skills with solid communication capabilities and practices, both oral and written.
• Leads through change and adversity, makes the tough call when needed, builds consensus when appropriate, motivates and encourages others.
• Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Ability to present data analysis in layman’s terms to ensure breadth of organizational understanding.
• To perform this job successfully, an individual should have working knowledge of Spreadsheet software and Word Processing/Presentation software. Must be able to operate a personal computer, calculator, and other office equipment and be able to learn and apply job specific programs and systems as needed.
• Working knowledge of statistics, medical informatics and data management. Collaborates with other staff to document data needs and metric definitions.
• Detail oriented, ability to work independently and possess time-management skills.
• Ability to take initiative and exercise independent judgment, decision making and problem solving expertise.
• Ability to understand and apply guidelines, policies and procedures.
• Knowledge of Regulatory Bodies (COP’s).

Other:

Use of usual and customary equipment used to perform essential functions of the position.

Work may occasionally require travel to other UPH facilities/hospitals.

Required to drive your own vehicle for business purposes.