Regional QA Consultant

This is a fully remote position, open to applicants in Kentucky.

📋 Description

• Develop, implement, educate, and oversee clinical programs that align with the Professional Nursing Standard of Care and Nursing Standard of Practice.

• Provide guidance and support to facilities regarding State and Federal Survey Regulations for Medicare and Medicaid Licensure and Certification, with a focus on Infection Prevention, Control & Immunization.

• Assist facilities in managing endemic, epidemic, and pandemic disease outbreaks.

• Aid in the creation of plans of correction and Allegations of Compliance for survey deficiencies; review documents prior to submission.

• Monitor facility adherence to submitted plans of correction.

• Supervise reportable events submitted to the Health Department and assist in resolving issues.

• Train facility administration and staff on nursing standards and survey regulations.

• Support Administrators in the hiring, training, and disciplinary processes for Directors of Nursing.

• Conduct monthly Regional Director of Nursing (DON) meetings focused on clinical program training and DON development.

• Assist facilities with clinical, MDS, dietary, social services, and regulatory policies and education.

• Collaborate with DONs on staffing structure and nursing per patient day (PPD) metrics.

• Visit facilities to evaluate and train clinical staff; develop action plans as needed.

• Attend regional meetings to provide clinical insights.

• Offer oversight and guidance to the MDS department.

• Facilitate monthly Regional MDS meetings for training and Case Mix Index (CMI) development; monitor and support with Recovery Audit Contractor (RAC) audits.

• Create regional tracking and trending reports for clinical metrics related to CMS 5-star ratings and assist facilities in improving their ratings.

• Support facilities in clinical risk management efforts.

• Collaborate with facility defense attorneys on lawsuits, depositions, reports, and document production.

• Review record requests to ensure appropriate document release.

⛳️ Requirements

• Required - Bachelor’s Degree in Nursing (BSN) or equivalent qualification.

• Graduation from an accredited Nursing Program.

• A minimum of 20 years of clinical and management experience is preferred.

• Preferred qualifications include MDS certification, experience as a Legal Nurse Consultant, or in Risk Management.

• Previous experience in a Regional or Corporate Nurse role.

• Familiarity with CMS/OIG surveys, including Jeopardy citations.

• Knowledge of Patient Care Coordination (PCC) is a plus.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and continuing education.

• Supportive work environment that values collaboration and innovation.