Direct support professional jobs in Linton Hall, VA - 1,228 jobs

Quality Provider Oversight Lead The Quality Provider Oversight Lead is responsible for the integrity, assurance, and improvement of the services delivered to HSCSN enrollees. This role works closely with HSCSN Quality Assurance leadership, various departments, Children's National partners, and HSCSN providers/practitioners as an enrollee advocate and quality provider liaison. The role develops and improves processes, addresses ongoing or potential quality deficiencies or risks, and ensures high value of care delivery for enrollees. Qualifications Minimum Education - Bachelor's Degree in nursing (BSN) (Required) Minimum Work Experience - 3-5 years of experience in the area of quality and health outcomes, home health agency oversight, provider site audits, provider engagement and education. Required Licenses and Certifications - Registered Nurse Responsibilities Develop and maintain provider engagement, oversight, and education using quality oversight processes. Proactively identify enrollee needs across the HSCSN provider network through the lens of quality monitoring, oversight, provider education, connection to care, delivery of services, and transition out of care in partnership with multiple teams and stakeholders. Ensure high quality provider engagement & collaboration through comprehensive training, quality site visits, and audits. Conduct ongoing quality site visits, provider education, trainings, and engagement activities to support care gap closure and QI initiatives. Collaborate with Compliance, Medical Affairs and Appeals and Grievances during complaints or potential quality issue (PQI) investigations including provider site visits, development and monitoring of corrective action plans. Audit home health agencies through site visits and point of care home visits. Lead Home health agency trainings/forums in collaboration with other HSCSN departments at least twice a year. Ensure Home health agency oversight, training, and monitoring of corrective action plans and receive individual and small group refresher training sessions and resource support. Convene quarterly Home Health Agency sub-committee in collaboration with HSCSN internal stakeholders (Medical Affairs, Provider Relations, Compliance, Quality). Ensure HSCSN provider focused quality engagement activities and home health oversight process and outcomes are included in the Quality Assessment and Performance Improvement (QAPI) Program, workplan, and evaluation. Participate in the Mortality Review Workgroup to review mortality events for prevention and improvement opportunities as well as measuring process measures related to contractual compliance with notification of mortality events. Schedule and coordinate internal monitoring/audits; conduct site visits of every home health agency in the HSCSN Provider Network at minimum annually, but more frequently when required by regulator, leadership, or required by corrective action plan. Conduct unannounced site visits on a routine basis to evaluate quality of clinical care and ensure compliance with contractural standards. Ensure that only home health agencies with a pediatric certificate of need (CON), administered by DOH, provide home health services to children and adolescents. Submit to DHCF annually, for review and approval, all on-site monitoring and evaluation tools utilized for home health agencies by the Quality. Submit any proposed revisions to monitoring and evaluation tools to DHCF for prior approval before use. Participate as home care lead in external audits (I.e. OSR) or accrediting efforts (I.e NCQA) to make sure HSCSN's policies and procedures are standards and striving for excellence. May perform other duties in addition to those outlined in this job description. Knowledge of Centers for Medicare & Medicaid Conditions of Participation for home health agencies, the DC regulations for home care agencies, and scope of practice for various provider types (RNs, LPNs, PCAs, etc). Quality improvement and general quality concepts (I.e. if no formal training, would be asked to complete IHI Basic Certificate within 90 days of start). Available home care services and provider types • Nursing assessment, diagnosis, planning, intervention, and evaluation process. The healthcare environment as it relates to the care delivery systems. NCQA standards and expectations including compliance requirements. Age-specific care. Culturally sensitive care. Employee Excellence Demonstrates understanding of quality of service and collaborates with co-workers to ensure excellence standard is achieved. Innovates through improvement of care and/or efficiency of operational processes. Dedicated to a standard of performance excellence and high quality. All In Embraces changes/improvements and actively participates in the implementation of new/improved programs, technology, new equipment, systems and resources that promote quality of care, safety and efficiency. Identifies, prioritizes and selects alternative solutions to determine best outcome. Action Oriented Maintains a high level of activity/productivity, meeting deadlines and appropriately prioritizing tasks to meet business demands. Anticipates problems and attempts to solve before they develop. Supervisory Responsibilities None Category III: Job does not involve exposure to blood, body fluids, non-intact skin or tissue specimens. Incumbent does not perform or help in emergency medical care or first aid as a part of his/her job. Protected Health Information Access Level Level IV - Full Access Incumbents in this job may access any protected health information associated to a customer's needs, the service(s) rendered and the position's functions. This job operates in a hospital or office environment. Physical Requirements Sedentary Work: Lifting 10 lbs. maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one that involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met. Travel Requirements Job requires travel to HSCSN network Home Health Agencies and provider office locations to complete quality site visits. DC Residents Encouraged to Apply. Health Services for Children with Special Needs (HSCSN) is an equal opportunity employer that evaluates qualified applicants without regard to race, color, national origin, religion, sex, age, marital status, disability, veteran status, sexual orientation, gender, identity, or other characteristics protected by law. Please note that it is the policy of Health Services for Children with Special Needs (HSCSN) to ensure a “drug‑free” work environment: a workplace free from the illegal use, possession or distribution of controlled substances (as defined in the Controlled Substances Act), or the misuse of legal substances by all staff (management, employees and contractors). Though recreational and medical marijuana are now legal in the District of Columbia, Children's National and its affiliates maintain the right, in accordance with our policy, to enforce a drug‑free workplace, including prohibiting recreational or prescribed marijuana. #J-18808-Ljbffr