Job Overview
Employment Type
Full-time
Compensation
Type:
Salary
Rate:
Range $71,200.00 - $127,200.00
Work Schedule
On-call
Benefits
Comprehensive benefits package
Incentive programs
recognition programs
equity stock purchase
401K contribution
Job Description
Shared Services, a vital component of LHC Group, operates as a leading post-acute care partner serving hospitals, physicians, and families nationwide. As part of the Optum family of businesses, Shared Services is dedicated to improving health and well-being, not only for patients but also for its employees. The organization prides itself on fostering meaningful connections among patients, their families, colleagues, and the communities served. This dedication creates a unique workplace culture centered on Caring, Connecting, and Growing together, making it an ideal place to build a rewarding career in healthcare.
Within this dynamic environment, the role of Quality Review ... Show More
Within this dynamic environment, the role of Quality Review ... Show More
Job Requirements
- Current CPR certification
- current driver's license, vehicle insurance, and access to a dependable vehicle or public transportation
- current and unrestrictive RN, PT, ST, or OT licensure in state of practice
- current COS-C or completion within 90 days of position effective date
- 1 years of Home Health experience as RN, PT, ST, or OT
- ability to analyze OASIS data at a high level and to accurately interpret and apply current OASIS guidelines, Conditions of Participation, and PPS guidelines to find opportunities for training and development
Job Qualifications
- Current CPR certification
- current and unrestrictive RN, PT, ST, or OT licensure in state of practice
- current COS-C or completion within 90 days of position effective date
- 1 years of Home Health experience as RN, PT, ST, or OT
- ability to analyze OASIS data at a high level and to accurately interpret and apply current OASIS guidelines, Conditions of Participation, and PPS guidelines to find opportunities for training and development
- effective verbal and written communication skills
- solid computer skills with proven ability to use MS Office applications, OASIS review software, and clinical documentation software as well as reports available in these programs
- exceptional organizational skills
Job Duties
- Thoroughly reviews the medical record as part of the OASIS review process and recommends the most accurate codes adhering to official OASIS guidelines as approved by the Centers of Medicare and Medicaid Services (CMS)
- reviews plan of care
- recommends edits to clinician and makes edits to the plan of care based on updated provider orders
- consistently engages directly with clinicians to improve accuracy of OASIS assessments, ensure proper development of the plan of care relevant to the primary focus of care and the patient assessment, and assure clinically appropriate discharges
- assesses clinical documentation to ensure that it supports the recommended OASIS and POC changes
- consults the clinician for clarification via electronic alerts when conflicting or ambiguous documentation is present, and abides by the clinician's acceptance or declination of changes
- provides OASIS education to clinicians when opportunities arise
- maintains accurate and timely review of OASIS time points and all related interdisciplinary documentation via the workflow in the electronic medical record (EMR) for timely OASIS locks and submission to the Centers for Medicare and Medicaid (CMS)
- develops and implements training based on evaluated competencies in documentation and clinical practice, edits from Strategic Healthcare Programs (SHP) alerts, and SHP reports for specific outcomes, adverse events, and utilization reports in conjunction with the OASIS Analyst, Clinical Director (CD), Executive Director (ED), or PI Coordinator
- collaborates with regional PI coordinator and agency to facilitate initiatives to improve quality outcomes and agency ratings
- identifies educational trends for agency and/or per clinician and discusses with Clinical Director and Quality Review Supervisor to further train/educate staff and improve OASIS accuracy
- reports to supervisor and operational leadership any continued lack of improvement or engagement from clinicians
- QR Specialist may be required to relocate to a nearby office and perform PCM workflow occasionally
- QR specialist will continue to participate in on-call rotation for their originating agency if they were in the on-call rotation prior to QR role
Job Qualifications
Experience
Mid Level (3-7 years)
Job Location
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