Summary of Essential Functions for the Position:

The Clinical Quality Specialist evaluates and audits for clinical compliance, regulatory compliance, and accreditation standards compliance. The Clinical Quality Specialist will participate in a systematic review of staff practices, documentation, and competencies to determine compliance with all regulatory bodies including, state practice, state, and federal regulations. Discuss recommendations and findings with the directors and audit the plan of improvement implemented post findings.

Qualifications / Licensure / Certification / Knowledge / Skills / Abilities:

• Extensive nursing experience with emphasis in home care industry experience preferred.
• Licensed Practical Nurse (LPN) or Registered Nurse (RN) preferred.
• In depth knowledge of OASIS with OASIS Certification preferred.
• Must have the ability to be process driven to achieve daily, monthly, quarterly, and yearly goals.
• Must demonstrate strong clinical auditing skills to identify deficiencies.
• Ability to demonstrate critical thinking, observation, problem identification & resolution skills.
• Acceptance and ability to demonstrate support of the core values and goals of Agency.
• Ability to demonstrate flexibility, initiative, and work with minimal supervision.
• Strong communication skills, both oral and in writing, with excellent interpersonal skills.
• Must demonstrate good customer relations skills with offices and staff and a commitment to providing quality service.
• Familiarity with healthcare laws, regulations, and standards.
• Ability to apply related knowledge specific to Federal, State, Local laws, and Medicare Coverage Criteria to ensure branch compliance.
• Proficient with a computer and Microsoft Word, Excel and Outlook software. Working knowledge of EMR database and Palmetto GBA E-services database.
• Must have a valid drivers license, auto liability insurance and reliable transportation.
• Travel may be required or may allow telework.

Educational Requirements:

License Practical Nurses must have a diploma from an approved school of practical or vocational nursing. Registered nurses must have at least a diploma or an associates degree in nursing (ADN) from an accredited nursing program.

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Working Conditions & Physical Requirements:

Work environment includes autonomy and can be stressful due to deadlines, multiple task and general compliance of law, rules, and regulations. The position requires visual acuity and dexterity, sitting, standing, some pushing, pulling, and lifting up to 25 pounds. Auto related accidents possible.