QUALITY REVIEW RN - HHH HOME HEALTH

Hoag Memorial Hospital Presbyterian • Full-time • Newport Beach, CA, US • 3m ago

Salary Range: $47.7200 - $73.3700 /hour. Actual compensation may vary based on geographic location, work experience, skill level, and education.

Job Summary

The OASIS Quality Review Nurse is a professional, registered nurse responsible for analyzing data integrity and consistency of OASIS documentation and assessment processes. This position will ensure appropriate ICD-10 coding and sequencing and will work with clinical staff to clarify documentation and data integrity issues.

Essential Functions:

Prospectively reviews all OASIS assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy.
Utilizes OASIS variation or alert reports when reviewing OASIS data.
Ensures appropriate ICD-10 coding and sequencing as it relates to the patient’s medical condition, including any co-morbidities. Consults with appropriate clinical staff to clarify any data integrity issues and works with clinician to make appropriate corrections per organization policy.
Reviews visit utilization for appropriateness of care guidelines and patient condition; reports potential financial losses and/or underutilization to the clinical manager/designee.
Notifies organization leadership of problematic trends as a result of OASIS review.
Works with managers to address trends that affect the agency’s outcome and process measures noted during OASIS review.
Makes OASIS inter-rater reliability visits with clinical staff.
Participates in Quality Improvement and Corporate Compliance activities as assigned.
Assists with other chart audit activities as assigned.
Maintains professional and technical knowledge by attending educational workshops and reviewing professional publications.

Job Qualifications

Education, Training and Experience

Required:

Registered nurse with current and valid license to practice in state of California
One (1) to two (2) years of clinical experience required.
Working knowledge of OASIS and ICD-10 coding. OASIS certification (COS-C) preferred; OASIS Home Health ICD-10 coding certification preferred. Knowledge of federal regulations and state licensure requirements.
Working knowledge of computer systems.
Possess and maintains current CPR certification.
Licensed driver with automobile that is in good working order and insured in accordance with organization requirements.
Excellent coordination and communication skills.
Detail oriented and able to work with minimal supervision.

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.

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