QAPI Clinical Review RN

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - QAPI Clinical Review RN (2384779)

QAPI Clinical Review RN - 2384779

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together.

We are currently offering a $10,000 sign on bonus for external candidates!

The Clinical Review QAPI RN plays a critical role in supporting healthcare quality initiatives through comprehensive medical record review, analyzing data integrity and consistency of OASIS Documentation, ensuring appropriate ICD-10 dx sequencing and working with clinical staff to clarify documentation and data integrity issues. Under the direction of the QAPI RN Supervisor, develops and implements agency wide QAPI program focusing on assessment and improvement in clinical care and supporting processes and compliance with state and federal regulation.

Working alongside an experienced team of clinical quality professionals, this individual will help ensure accurate and timely data collection, support compliance efforts, and contribute to improving care outcomes across the network. This role offers the opportunity to collaborate directly with providers, clinical teams, and healthcare organizations while making a meaningful impact on quality performance and patient care. This role will also have a hybrid schedule working 3 days in office.

• Reviews all OASIS assessments to ensure timeliness, appropriateness, completeness and compliance with federal and state regulations
• Utilizes OASIS variation or alert reports when reviewing OASIS data
• Ensures appropriate ICD-10 coding sequencing as it relates to the Admission summary
• Consults with appropriate clinical staff to clarify any data integrity issues and works with clinician to make appropriate corrections
• Notifies agency leadership of problematic trends as a result of OASIS review
• Works with Clinical Leadership to address trends that affect the agency's outcome and process measure noted during OASIS review
• Participates in Quality Improvement and Corporate Compliance activities as assigned
• Maintains professional and technical knowledge by attending educational workshops and reviewing professional publications
• Participates in Administrator on-call rotation
• Assists in the development and implementation of an agency wide QAPI program via data collection, analysis, reporting, and benchmarking
• Prepares and presents reports regarding QAPI activities to agency leadership
• Serves as a resource for the electronic clinical information system; utilizes Southwest Medical Home Health ("Agency") technology resources to derive performance improvement
• In collaboration with Agency leadership, fosters a culture of clinical excellence via continuous assessment and quality of focus on performance improvement; acts as a resource to all levels of staff; participates in development of agency policies and processes; participates in and coordinates state and federal surveys to include corrective action plans and appropriate documentation to support Agency compliance with corrective action plans
• Complete inter-rater reliability testing and required training to support consistent and accurate medical record abstraction
• Perform quality improvement audits and chart reviews to identify and document required clinical information
• Provide education and guidance to physicians, nurses, and other clinical and non-clinical staff on quality measures, documentation practices, and related initiatives
• Collaborate with internal quality team members to drive performance improvement efforts and maintain data integrity

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.

• Current, unrestricted Nevada RN license, or temporary Nevada RN license with the ability to obtain permanent licensure upon expiration
• BLS CPR certification
• 3+ years of clinical RN experience, preferrable in Home health setting
• Medical record review and chart abstraction experience
• Proven working knowledge of OASIS and ICD 10 coding
• Proven knowledge of federal regulations and state licensure requirements
• Proven excellent coordination and communication skills
• Experience educating physicians, registered nurses, and/or clinical and non-clinical staff
• Experience working with Electronic Medical Records (EMR) systems
• Driver's License with automobile in good working order and maintain personal auto insurance coverage in accordance with organization requirements
• Ability to work three days in office and two days at home

• Oasis Certification (COS-C) preferred. Home Health ICD-10 coding certification
• 2+ years of clinical quality experience, preferably in Home health
• Experience…