Quality Reviewer - RN

Overview

Director of Quality and Patient Safety and within established agency policy and procedures, the Quality Reviewer provides support and assists the Agency in meeting the objective of the Quality and Safety Dept. which includes but is not limited to meeting regulatory requirements, coding accuracy, OASIS accuracy, documentation review and ongoing education to staff.

Responsibilities

• Reviews OASIS and visit notes to ensure accuracy in documentation, accurate coding and sequencing of diagnosis as governed by regulatory rules and regulations
• Audits clinical records for appropriate utilization of services, quality outcome measurement, standards of practice and to ensure regulatory compliance.
• Participates in the implementation and evaluation of the agency quality program to ensure achievement of quality outcomes.
• Assists with the developing and providing of educational programs for direct care staff that will improve individual and group performance on OASIS/ documentation.
• Works individually with clinicians to promote accuracy with OASIS and documentation requirements to meet regulatory standard including but not limited to field supervision.
• Participates in staff meetings to facilitate ongoing education as it pertains to clinical, quality, regulatory and compliance.
• Contributes in developing education plans and in attaining relevant goals.
• Provides excellent customer service to employees, customers and physicians according to agency standards.
• Participates in QAPI Committee

Required Qualifications

• Licensed Registered Nurse in the state of Massachusetts
• Baccalaureate degree from a program accredited by the National League for Nursing preferred (Equivalent combination of education, training, and experience may be substituted for this criterion).
• Experience in OASIS documentation, certification preferred.
• Experience in ICD-10 coding, certification preferred.
• Five years of nursing experience, of which 2-3 years are in field of home health.
• Possess strong leadership skills, strong working knowledge of home health regulatory requirements.
• Demonstrates ability to work in a team oriented environment.
• Hospice experience a plus.