ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Clinical Record Reviews (CRR) including a focus on: verification of documentation, quality of care provided, visit utilization, adherence to the plan of care/agency policies & procedures, evidence of communication between all disciplines, etc. to ensure proper documentation to maximize reimbursement.
Maintain agency CRR compliance at 80% or greater.
Communication with the Clinical Manager/Administrator of trends as presented through QA data, situations requiring process changes or staff training/action based upon QA data.
Participation in Agency orientation & in-service training programs.
Other duties as assigned
QUALIFICATIONS AND EXPERIENCE:
A Registered Nurse (preferred) with a current state license.
A minimum of 2 years of home health experience, 1 of which shall include experience in QA of a home health agency.
Must have a working knowledge of state regulations/requirements, good organizational, interpersonal and judgement skills.
Must be able to develop action plans and resolve identified inconsistencies.
Knowledge of homecare regulations, CMS guidelines, accreditation standards, and documentation requirements.
Experience with chart audits, quality improvement processes, and compliance review preferred.
Familiarity with OASIS, electronic medical records (EMR), and home health billing documentation is highly desirable.
Strong analytical, organizational, and problem-solving skills.
Excellent written and verbal communication skills.
Ability to work independently and collaboratively with interdisciplinary teams.
Able to hear, speak, understand and communicate effectively in English.