Clinical Consultant responsibilities include: providing Skilled Nursing Facility consulting and auditing services related to regulatory compliance, survey management, MDS coding, billing and reimbursement accuracy, QAPI program implementation, 5-star rating improvement, infection control, facility leadership and operational development, and clinical program development. Advanced skills required in professional writing, creation of substantive action plans and reports, research, training content development and teaching/presenting on SNF quality, reimbursement and regulatory topics through in-person workshops and via webinars. Minimum of 5 years SNF/NF leadership experience required with background as RN-Nursing Home Administrator, DON/ADON or in a multi-site Clinical Management/QAPI or SNF/LTC Consultant role preferred.
Proactive LTC Consulting is located in Evansville, IN with staff and clients located across the country. Our consulting team is able to work from home approximately 50% of the time, with travel for client facility visits the remaining time. Candidates within reasonable driving distance of Kentucky are preferred. This position involves SNF site visits to drive quality assurance and performance improvement in combination with remote audit and consulting support from your home office.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:
- Maintains clinical & regulatory knowledge in accordance with current geriatric care standards of practice, including but not limited to national association practice standards, state practice acts, state board of health regulations, CMS Requirements of Participation, and payor guidelines
- Identifies facility quality assurance and program development needs, develops work plans, establishes clinical and fiscal goals, and partners with clients to implement solutions to meet facility quality objectives (e.g. 5 Star Survey, Infection Prevention and Control and Outbreak Management)
- Completes comprehensive clinical documentation audits of medical records and MDS coding accuracy to ensure compliance with Medicare/RAI guidelines, state (Medicaid) documentation requirements, and standards of care for the conditions being treated. A strong foundation in MDS coding and PDPM is expected.
- Applies SNF QAPI framework for quality improvement and demonstrates success in directing efforts to achieve improvement in SNF Quality Measures
- Conducts mock surveys to aide facilities in survey preparedness activities and similar quality assurance activities to promote continual quality improvement.
- Creates effective reports to summarize audit and consultant quality review findings with corrective action plan recommendations as applicable.
- Provides constructive feedback to clients in a professional manner related to clinical/reimbursement systems and potential opportunities for improvement.
- Develops useful, innovative tools & resources to guide client clinical, compliance, and reimbursement accuracy efforts
- Creates practical training material and presents relevant and engaging education in live and webinar formats. Comfort level and experience in presenting to large and small groups is necessary.
- Exhibits exceptional writing skills to complete tasks such as the development of policies and procedures which comply with established standards.
- Demonstrates skill in conducting research in follow up to client specific clinical, billing and regulatory inquiries.
- Assists clients to complete ADR (Additional Documentation Request) and Medicare or other payor claim denial management activities following company standards.
- Communicates/interacts with client/facility personnel in a warm and professional manner to ensure continued satisfaction with delivery of consulting services.
- Complies with all Infection Control, Universal Precautions and OSHA standards for healthcare professionals.
- Consistently demonstrates sound judgment and provides ethical guidance to clients in the assessment/review, action plan development, implementation of corrective action, and follow up of established programs for SNF/long term care practices.
- Maintains privacy and confidentiality of clients/business associates and is compliant with HIPAA standards and cybersecurity program standards
- Regional travel may be required approximately 50% of the time with potential for occasional travel longer distances.
RECOMMENDED MINIMUM POSITION QUALIFICATIONS:
- Registered Nurse (RN) required with minimum of five years of experience in LTC/Skilled Nursing Facility
- SNF/LTC multi-site management experience preferred.
- Knowledgeable in SNF/LTC Regulations, Health Inspection Survey Management, and SNF/LTC Reimbursement including RAI guidelines, Kentucky Medicaid/Case Mix Index (CMI,) and state nursing facility documentation guidelines.
- Current State Licensure/Certification in good standing
- Strong organizational skills with the ability to coordinate multiple projects, prioritize obligations, and consistently meet deadlines
- Regular Attendance.
- Excellent ability to interact and develop professional advisory relationships including skills in verbal communication with a demonstrated ability to share constructive feedback in a manner that motivates growth
- Competence in interpreting data related to risk management, quality trends, and reimbursement accuracy providing succinct analysis and pragmatic action plans to drive performance improvement
- Continually updates knowledge related to computer technology and is currently proficient in Microsoft Office including PowerPoint, Word, Outlook and Excel; experienced users of commonly used SNF/NF software platforms including Point Click Care and Matrix are preferred.
Updated 6.19.24
The essential functions described here are representative of those an employee encounters while performing the basic functions of a Clinical Consultant. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
This Company Describes Its Culture as:
- Detail-oriented -- quality and precision-focused
- Outcome-oriented -- results-focused with strong performance culture
- Team-oriented -- cooperative and collaborative
Schedule:
- Monday to Friday
- Day shift
Benefits:
- Health insurance
- Dental insurance
- Vision insurance
- Retirement plan
- Paid time off
- Professional development assistance
Work Location:
Close Preview
Job Type: Full-time
Pay: $80,000.00 - $104,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Continuing education credits
- Dental insurance
- Disability insurance
- Flexible schedule
- Flexible spending account
- Free parking
- Health insurance
- License reimbursement
- Life insurance
- Malpractice insurance
- Paid sick time
- Paid time off
- Travel reimbursement
- Vision insurance
Medical specialties:
Physical setting:
- Long term care
- Nursing home
- Skilled nursing facility
Supplemental pay types:
Weekly schedule:
Application Question(s):
- Describe your technology proficiency level including experience with specific software
Education:
Experience:
- Nursing: 5 years (Required)
License/Certification:
- RN License (Required)
- Infection Preventionist Certification (Preferred)
- RAC-CT Certification (Preferred)
Work Location: Hybrid remote in Louisville, KY 40202