RN Quality Assurance
Company: Hope at Home Health Care
Posted on: May 14, 2022
Job DescriptionBecome a part of the Hope At Home Family!We
currently have a position available for an experienced Home Health
Care Quality Assurance RN!This position is only for an onsite
location in our Southfield office and the individual will provide
clinical management support throughout our service area. Must have
Wellsky/Kinnser Software Knowledge to qualify for this position. We
offer competitive pay. Benefits include health, dental, vision, and
paid time off for full-time employees.ESSENTIAL JOB
- Review all Medicare and other episodic payers' clinical records
to assure appropriate documentation for reimbursement. This review
includes verification of appropriate documentation, quality of care
provided, visit utilization, appropriate contacts with physicians,
adherence to the care plan, and evidence of communication between
- Oversee the maintenance of clinical records and files to comply
with Conditions of Participation (COPs), using measurements, as
licensure, certification, and accreditation results.
- Provide new staff orientation and 90 day and annual in home
care competency reviews.
- Audit charts for clinical oversight and compliance and
adherence to the Medicare guidelines.
- Oversees clinical activities, including patient assessments,
care plan development, service level determination, on-site field
visits, and the implementation/coordination/maintenance/evaluation
of care plans.
- Ensure service quality and participates in care coordination to
ensure proper communication between caregivers, patients, referral
sources and payers. Discuss operational issues, update staff on
new/changed regulations and review records/documentation to ensure
regulatory and in-house compliance.
- Be accountable for financial responsibility related to budget
goals through utilization, documentation, providing appropriate and
accurate patient care, case mix weight, and appropriate utilization
of delivery of patient care.
- Conduct and/or delegate the assessment and reassessment of
patients, including updating of care plans and interpreting patient
needs, while adhering to Company, physician, and/or health facility
- Coordinate communication between team members/attending
physicians/caregivers to ensure the appropriateness of care and
outcome planning and ensures compliance through review of
documentation and care coordination activities.
- Participate in performance improvement activities, maintain
ongoing clinical knowledge through internal/external training
programs, provide interpretation of knowledge and direction to
- Identify clinical problem areas and documents deficiency trends
in a proactive approach.
- Educate administrative and clinical associate staff in the
correction of these deficiencies.
- Assist with quality improvement and Medicare compliance
- Review OASIS documents for accuracy and completeness prior to
locking and submitting data electronically. Explain and mentor
clinicians and staff on COP's and on billable skilled visits.
- Educate and mentor clinicians one on one (in person or over the
phone) regarding concerns, questions, accuracy of OASIS data, and
other related documents, that are being reviewed.
- Facilitate the ICD-9/10 coding of the Plan of Treatment based
on OASIS data and patient assessment documentation that is assessed
at the bedside.
- Collaborate with leadership to ensure effective and efficient
episodic management.The above statements are intended 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
- Current Registered Nurse
- EMR - Kinnser experience (WellSky)
- Minimum of three years of clinical home care experience
- Knowledge of state and federal home health agency
regulations/Conditions of Participation and Compliance standards
- Knowledge of clinical policies and procedures and ability to
- Good organization, communication, human relations skills, and
Keywords: Hope at Home Health Care, Southfield , RN Quality Assurance, Healthcare , Southfield, Michigan
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