Description
**Opportunities at WellMed,** part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind **Caring. Connecting. Growing together.??**
The Home Health Quality Assurance RN, under the supervision of QA RN, audits clinical records for compliance to all applicable laws, federal and state rules and regulations and Agency's policies and monitors factors which directly and indirectly influence the care rendered to the patients.
**Primary Responsibilities:**
Performs audits of 100% of all OASIS and PT/OT/ST evaluations for the assigned Branch and clinician alpha under the supervision of a Registered Nurse, to make sure the clinician/therapist followed relevant regulatory guidelines, policies and procedures
Performs 75% to 100% audits of all daily skill visits notes performed by the RN's, LVN or therapist, depending on the clinician's return for review records in the previous 90 day period. Duty performed under the supervision of the manager for the QA department
Evaluates the documentation of medical care to make sure the clinician/therapist followed relevant CMS regulatory guidelines and the Agency's policies and procedures
Checks to make sure that all physician orders are followed and that there is an order in the EMR system for the skill visit performed by the clinician
Verifies that all necessary documentation is included in the EMR
Returns OASIS/evaluation/skill visit note to the clinician if additional documentation is needed, for correction or if additional information is necessary to be in compliance
Based on review of clinical documentation, identify potential quality of care issues and potential fraud/waste/abuse
Monitors and reports market and clinician specific trends identified to manager for further review, action or additional clinician education
Assists in developing processes to improve quality of notes
Educates clinician on proper documentation needs for regulatory compliance
Establishes a trusting relationship with clinicians and co-workers
Exhibits professionalism and is courteous with all clinicians and co-workers
Demonstrates knowledge and observance of Patient's Bill of Rights and Notice of Privacy Practices
Participates in educational programs and all required in-service programs to maintain comprehensive QA knowledge base, as assigned by supervisor
Complies with all Homecare Dimensions, Inc. Agency's policies and procedures. Promotes and maintains an agency environment that is in compliance with federal, state, and local regulatory agencies. Participates in the agency's endeavors for accreditation, licensing and professional recognition according to state, federal and/or CHAP's requirements
Demonstrates personal responsibility with regard to attendance and punctuality
Maintains privacy and confidentiality with regard to all patient, staff and agency information
Expresses verbal and written communication in a clear, positive and cooperative manner
Demonstrates flexibility, enthusiasm and willingness to cooperate while working with others or in place of others, as necessary
Promotes the agency image by adhering to the Dress Code
Performs all other QA related duties as assigned
Maintains RN licensure current, at all times, and in good standing with the Board of Nurse Examiners for the state of employment
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
Graduate of an accredited RN program
Current licensure as a Registered Nurse in good standing with the Board of Nurse Examiners for the state of Texas
2+ years of experience as an RN in a home health care environment
Proven ability to define problem, collect data, establish facts, interpret an extensive variety of technical, medical, regulatory instruction and deal with numerous issues to draw a valid conclusion
Proven excellent verbal and written communication skills
Proven ability to interact productively with individuals and with multidisciplinary teams
Proven excellent organizational and prioritization skills
**Preferred Qualifications:**
2+ years of Home Health QA experience
Proficient computer skills, including Microsoft Word, Excel and Outlook
**Physical & Mental Requirements:**
Ability to lift up to 20 pounds (must be able to lift documents/boxes from one location to another, if necessary)
Ability to push or pull heavy objects using up to --- pounds of force
Ability to sit for extended periods of time
Ability to stand for extended periods of time
Ability to use fine motor skills to operate office equipment and/or machinery
Ability to properly drive and operate a personal/company vehicle
Ability to receive and comprehend instructions verbally and/or in writing
Ability to use logical reasoning for simple and complex situations
-At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.-
-Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.-
-UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.-
Compensation Information:
$0.0 / - $0.0 /
Starting At: 0.0
Up To: 0.0
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