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Quality Assurance Specialist - Home Health

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UNC Health Careers

Chapel Hill, NC, US

1 month ago
full-time
degree mentioned

Job highlights

Qualification

Bachelor’s degree in Nursing (BSN) from a state accredited school of professional nursing. Current RN license to practice in NC. Must be Oasis Certified (HCS-O,COS-C) or obtain certification within one (1) year of employment. Adult CPR. If a Bachelor's degree: requires four (4) years of related experience and/or training. A minimum of two (2) years of experience in Home Health. Must be professional with effective critical thinking and problem solving skills. Strong interpersonal and communication skills for cross department collaboration. Strong team player with high attention to detail that can adapt easily to continous change

Responsibility

The RN Quality Assurance Specialist will oversee the clinical documentation of the direct care clinical staff to ensure it is compliant with Medicare, Medicaid/state/federal regulations, and agency policies and guidelines; works closely with Performance. Improvement (PI) coordinator and agency educator to identify areas of education as needed; provides guidance and education to field staff regarding accurate, thorough documentation; ensures timely submission and approval of the patient’s plan of care and provider orders to ensure compliance with state and federal regulations. Demonstrates working knowledge of regulatory and provider guideline, updating knowledge base continuously through self study and in-service attendance. Maintains awareness of current payor provider agreements in order to complete 485 and OASIS appropriately. Assesses and interprets patient data as needed to provide guidance to Case Managers on patient needs relative to his/her age and conditions. Consults with patient case managers/team leaders for care coordination as necessary. Promote and maintains interpersonal communication with all team members, clinicians and physicians. Demonstrates ability to educate, develop and stimulate the professional growth and development of staff members. Identifies staff educational needs to ensure safe and effective patient clinical management. Recommends, plans and or participates in staff development programs for employees. Ensures that all patient OASIS assessments are submitted by staff and that they are complete and compliant with Medicare/Medicaid/state/federal regulations and agency policy. Responsible for reviewing for patient assessments for completeness, locking and submitting the assessment per regulatory guidelines. This includes, but not limited to: coding and diagnoses, patient short and long-term goals with end points for all services, orders/goals for all disciplines, and notifies the clinical staff assessment revisions as needed. Manages the implementation of nursing process to ensure quality of patient care delivery and monitors outcomes of care as appropriate. Participates in employee educational programs to improve the quality of the patient plan of care and OASIS assessments. Meets or exceeds daily assessment review productivity. Works with the Quality Manager and Director in the development and implementation of departmental goals and standards. Audits patient records for completeness of documentation and adherence with agency, organizational, state and federal regulations and payor requirements. Provides for quality review (QA) related education and assessment review with new staff during the onboarding and orientation, or as indicated. Provides for other duties or tasks as assigned

Benefits

  • Standard Hours Per Week: 40.00
  • Salary Range: $29.98 - $43.10 per hour (Hiring Range)
  • Pay offers are determined by experience and internal equity

    Job Description

    Description

    Description Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve. Summary: The RN Quality Assurance Specialist will oversee the clinical documentation of the direct care clinical staff to ensure it is compliant with Medicare, Medicaid/state/federal regulations, and agency policies and guidelines; works closely with Performance Improvement (PI) coordinator and agency educator to identify areas of education as needed; provides guidance and education to field staff regarding accurate, thorough documentation; ensures timely submission and approval of the patient’s plan of care and provider orders to ensure compliance with state and federal regulations. Responsibilities: 1. Demonstrates working knowledge of regulatory and provider guideline, updating knowledge base continuously through self study and in-service attendance. Maintains awareness of current payor provider agreements in order to complete 485 and OASIS appropriately. 2. Assesses and interprets patient data as needed to provide guidance to Case Managers on patient needs relative to his/her age and conditions. Consults with patient case managers/team leaders for care coordination as necessary. 3. Promote and maintains interpersonal communication with all team members, clinicians and physicians. 4. Demonstrates ability to educate, develop and stimulate the professional growth and development of staff members. Serves as clinical resource to home health staff as well as physicians and their office staff as related to home care services, orders and diagnoses. 5. Identifies staff educational needs to ensure safe and effective patient clinical management. Recommends, plans and or participates in staff development programs for employees. 6. Ensures that all patient OASIS assessments are submitted by staff and that they are complete and compliant with Medicare/Medicaid/state/federal regulations and agency policy. 7. Responsible for reviewing for patient assessments for completeness, locking and submitting the assessment per regulatory guidelines. This includes, but not limited to: coding and diagnoses, patient short and long-term goals with end points for all services, orders/goals for all disciplines, and notifies the clinical staff assessment revisions as needed. 8. Manages the implementation of nursing process to ensure quality of patient care delivery and monitors outcomes of care as appropriate. 9. Participates in employee educational programs to improve the quality of the patient plan of care and OASIS assessments. 10. Meets or exceeds daily assessment review productivity. 11. Works with the Quality Manager and Director in the development and implementation of departmental goals and standards. 12. Audits patient records for completeness of documentation and adherence with agency, organizational, state and federal regulations and payor requirements. 13. Provides for quality review (QA) related education and assessment review with new staff during the onboarding and orientation, or as indicated 14. Provides for other duties or tasks as assigned. Other Information Other information: Education Requirements: ● Bachelor’s degree in Nursing (BSN) from a state accredited school of professional nursing Licensure/Certification Requirements: ● Current RN license to practice in NC ● Must be Oasis Certified (HCS-O,COS-C) or obtain certification within one (1) year of employment ● Adult CPR Professional Experience Requirements: ● If a Bachelor's degree: requires four (4) years of related experience and/or training. ● A minimum of two (2) years of experience in Home Health Knowledge/Skills/and Abilities Requirements: ● Must be professional with effective critical thinking and problem solving skills. Strong interpersonal and communication skills for cross department collaboration. Strong team player with high attention to detail that can adapt easily to continous change. Job Details Legal Employer: STATE Entity: UNC Medical Center Organization Unit: Orange Home Health Skilled Nur Work Type: Full Time Standard Hours Per Week: 40.00 Salary Range: $29.98 - $43.10 per hour (Hiring Range) Pay offers are determined by experience and internal equity Work Assignment Type: Hybrid Work Schedule: Day Job Location of Job: US:NC:Chapel Hill Exempt From Overtime: Exempt: Yes This is a State position employed by UNC Health Care System. Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.