Raleigh, North Carolina
Raleigh, North Carolina
Wilmington, Ohio
Roanoke, Virginia
Saint Louis, Missouri
Spokane, Washington
City in western, Tennessee
Posted: 16-Aug-24
Location: San Antonio, Texas
Salary: Open
Categories:
Internal Number: 140992114
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
- 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.
