To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
The QA Home Care Reviewer will facilitate the process of improving clinical documentation through extensive clinical documentation reviews and concurrent interactions with clinicians to fully capture a patients condition, complications and co-morbidities. The QA Home Care Reviewer will educate nurses, clinicians, and staff on documentation improvement opportunities, OASIS compliance, reimbursement and relevant quality and performance improvement opportunities. The QA Home Care Reviewer will identify documentation issues related quality of care and will seek resolution through the appropriate channels. Responsible for review of all clinical records regarding the OASIS and other clinical documentation and ensuring compliance with applicable State and Federal laws and regulations, Medicare guidance, and other policies and procedures. EEO/AA/Disability/Veteran Responsibilities:EDUCATION
Registered Nurse with active license, BSN preferred. HCS-D coding certification preferred. LPN with an active license accepted with a minimum of three years experience required in Quality Assurance in Home Health and Hospice .
EXPERIENCE
At least three (3) years of recent clinical nursing experience required. Home Health and Hospice preferred. Clinical expertise required. At least one (1) year of OASIS QA review experience required. Experience conducting quality assurance and continuous improvement activities.
LICENSURE
RN license required. LPN with an active license accepted with a minimum of three years experience in Quality Assurance in Home Health and Hospice in lieu of RN license. HCS-D Home Care Coding Certification a plus. COQS (Certified OASIS Quality Specialist) or HCS-O (Certified Home Care Clinical Specialist) required within 12 months of hire.
SPECIAL SKILLS
Excellent communication, negotiation and organizational skills. Adaptability to a wide variety of interpersonal encounters throughout the health system and community. Comprehensive understanding in use of medical record to extract data. Working knowledge of third party and prospective payment systems relating to home care and hospice. Thorough knowledge of home care quality assurance process. Computer PC literacy required. Must be able to work collaboratively and independently. Must have keen eye to detail. Must be adaptable, flexible, have ability to learn quickly, use critical thinking, and be able to motivate staff. Strong computer skills.
PHYSICAL DEMAND
Must be capable of standing, walking, and bending. Ability to communicate clearly and confidently to providers the program goals and documentation issues using email, in person communication, telephone and other written and electronic forms of communication.
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