JOB SUMMARY:

The Quality Assurance Coordinator is a qualified person appointed by the Agency’s Director of Clinical Services and the Quality Assurance Director who is responsible for reviewing patient’s medical records. This review includes: Verification of appropriate documentation, visit utilization, appropriate contacts with physicians and evidence of communication between disciplines. Audit charts to ensure completeness as per Medicare and The Joint Commission guidelines

QUALIFICATIONS:

  1. Two (2) years experience in Home Health Care Quality Assurance,
  2. Must possess excellent interpersonal and telephone skills.
  3. Demonstrated experience in Quality Control measures.
  4. Must be able to complete multi-tasks and meet multi-deadlines.
  5. Has effective time management and organizational skills, and works independently.
  6. The ability to work independently with minimal supervision and maintain composure when working under pressure.
  7. Ability to develop and maintain professional relationships along with a strong sense of confidentiality.
  8. Ability to maintain confidentiality and assume responsibility.
  9. Demonstrated skills in Oasis documentation.
  10. Working knowledge of Medicare Conditions of Participation
  11. Working knowledge of State and Federal regulations regarding Home Health Care
  12. Solid decision making skills.

RESPONSIBILITIES:

  1. Monitors patient clinical records concurrently and retrospectively, utilizing agency thresholds and indicators.
  2. Reviews clinical records for completeness, accuracy, and appropriateness of answers to OASIS questions as related to other information found in the clinical record.
  3. Audits clinical records for completeness on an on-going basis.
  4. Ensures proper coding of OASIS and documentation for proper payment.
  5. Assists Agency personnel in care coordination of patient/client services.  Serves as a liaison between the Organization, referral sources, patients/clients and Agency personnel.
  6. Assists and/or coordinates development of performance improvement studies as requested by the Director of Quality Assurance.
  7. Stays up-dated with changes in OASIS and Home Health PPS requirements, reports such changes to Agency Administrator, Supervising Nurse and field clinicians.
  8. Represents the agency at all times in a professional, ethical and loyal manner.
  9. Complies with agency policies and procedures.
  10. Communicate with the Quality Assurance Director of any notable situations requiring more extensive training or action.
  11. Other duties as requested by the Administrator / Clinical Director and the Director of Quality Assurance.

WORKING ENVIRONMENT:

Works indoors in Agency office and patient homes and travels to/from patient homes.

JOB RELATIONSHIP:

  1. Supervised by: Director of Quality Assurance

RISK EXPOSURE:

Low risk

LIFTING REQUIREMENTS:

Ability to perform the following tasks if necessary:

  • Ability to participate in physical activity.
  • Ability to work for extended period of time while standing and being involved in physical activity.
  • Moderate lifting.
  • Ability to do extensive bending, lifting and standing on a regular basis.

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