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Quality Assurance Review Nurse-Registered Nurse (RN)

Company: Dependable Health Services
Location: Oro Valley
Posted on: November 22, 2020

Job Description:

Location: Tucson, Arizona Dependable Health Services is seeking a Quality Assurance Review Nurse- RN to join our Tucson Team. The QA RN is a professional registered nurse responsible for analyzing data integrity and consistency of OASIS documentation and assessment process. The position will ensure appropriate ICD-10 coding and sequencing and will work with clinical staff to clarify documentation and data integrity issues. ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES Prospectively reviews OASIS assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy. Review of written physician orders appropriately. Reviewing clinical visit notes to ensure documentation matches plan of care and orders appropriately. Coordinating and collaborating with the leadership, clinical managers, coder, field clinicians, patients, and physicians to ensure all planned treatment/goals and interventions are provided to the patient according to the patients plan of care. Utilizes OASIS variation or alert reports when reviewing OASIS data. Ensures appropriate ICD-10 coding and sequencing as it relates to the patient's medical condition, including any co-morbidities; PDGM appropriateness. Consults with appropriate clinical staff and CareInsights (WellSky) to clarify any data integrity issues and works with clinician to make appropriate corrections per organization policy. Reviews visit utilization for appropriateness of care guidelines and patient condition; reports potential financial losses and/or underutilization to the clinical manager/designee. i.e. PDGM and LUPA thresholds Notifies organization leadership of problematic trends as a result of OASIS review. Works with managers to address trends that affect the agency's outcome and process measures noted during OASIS review. Works with new hires/orientation to train clinical documentation/QA. Must track hospitalizations/transfers/discharges and readmissions-daily. Meets with clinical staff to provide education and learning opportunity for QA improvement outcomes. Participates in Quality Improvement and Corporate Compliance activities as assigned. Assists with other chart audit activities as assigned. Maintains professional and technical knowledge by attending educational workshops and reviewing professional publications. The above states are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job related tasks other than those stated in this description. POSITION QUALIFICATIONS Registered nurse with current license to practice professional nursing in the state. One (1) to two (2) years clinical home health experience required. Working knowledge of OASIS and ICD-10 coding. OASIS certification (COS-C) preferred; OASIS Home Health ICD-10 coding certification preferred. Knowledge of federal regulations and state licensure requirements. Working knowledge of computer systems. Possess and maintains current CPR certification. Licensed driver with automobile that is in good working order and insured in accordance with organization requirements. Excellent coordination and communication skills. Detail oriented and able to work with minimal supervision. We are an Affirmative Action/Equal Opportunity Employer for all individuals regardless of race, color, religion, gender, age, national origin, marital status, sexual orientation, status as a protected veteran, genetic information, status as a qualified individual with a disability and any other basis protected by federal, state or local laws. #DHS123 For more information, or to apply now, you must go to the website below. Please DO NOT email your resume to us as we only accept applications through our website. https://www.applicantpro.com/openings/dependablehealth/jobs/1588324-348732

Keywords: Dependable Health Services, Oro Valley , Quality Assurance Review Nurse-Registered Nurse (RN), Healthcare , Oro Valley, Arizona

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