Quality Assurance Nurse

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.