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Quality Assurance Nurse (RN)

Location: Saint Louis
Posted on: May 15, 2022

Job Description:

AW Health Care is currently seeking a Full Time Quality Assurance Nurse to support our Home Health division, This is a remote, work from home role. However, the successful candidate will be located within 60 miles of the metro St Louis area and be able to perform field nursing when emergency situations warrant. Why Work at AW Health Care?

  • We at AW Health Care feel that placing our clients and team members first, is our top priority. We believe in the saying, happy team members make for happy clients and we certainly strive to live by these words.
  • We understand that while starting a new job may be exciting, it can also be a little stressful. That is why we invest the time to welcome and train each and every team member. Beginning with our thorough orientation process, we welcome new employees into the AW Health Care family and strive to provide them with the tools and resources needed to make the transition as easy as possible.
  • We feel that it is important for our team members to have a voice, but also to feel like that voice is heard and that they are respected. This is reflected in the retention and progress of our long-term team members.
  • We encourage continuing education and offer countless opportunities for advancement.
  • On top of all that AW Health Care is consistently ranked among the Top Places to Work and Top Women Owned Businesses in the St Louis area. Why wouldn't you want to work here?AW Health Care Benefits:AW Health Care offers its' employees a wide range of benefits including:
    • Medical
    • Dental
    • Life
    • Matching 40
    • And a wide range of s1K
    • Paid Time OffSupplemental benefit options including, but not limited too:
      • Additional Life Insurance
      • Short Term/Long Term Disability
      • Accidental Death and DismembermentJob Summary:The Quality Case Manager is a registered nurse who is responsible for all tasks related to Quality and Clinical Management of patients. This includes ensuring that an individual plan of care is developed which promotes self-care and quality of life through efficient resource utilization. This person is responsible for developing, implementing, monitoring, tracking and reporting on quality assurance projects and quality initiatives for AW Healthcare patients. This person performs chart review to ensure proper utilization of services to meet patient care needs and regulatory compliance through the use of quality indicators, which are developed in collaboration with the administrative staff. Responsibilities:
      • Maintains a knowledge base of current HIPAA/regulatory/compliance issues
      • Knowledgeable and proficient regarding OASIS data and other needed documentation
      • Knowledgeable and adheres to AW Healthcare policies and procedures.
      • Knowledgeable and proficient in the use of computer software programs in use by AW Healthcare.
      • Assists and supports staff in reconsideration of denials.
      • Conferences with staff as needed regarding documentation and any identified areas of concern in service utilization or regulatory compliance.
      • Tracks problems/concerns/weak areas noted in reviews and reports trends and in-service needs.
      • Updates supervisor and field staff to trends that are identified in chart review.
      • Promotes agency services and programs by participating in public relations efforts or community activities.
      • Recognizes limitations and conferences with supervisor/designee as needed.
      • Attends and actively participates in staff meetings and assigned committees.
      • Understands and actively participates in performance improvement program.
      • Designs, reviews, updates and implements Quality Improvement Plan annually, while monitoring and reporting progress quarterly.
      • Coordinates quarterly peer review.
      • Prepares written summary of Quality Indicator findings of internally benchmarked standards as well as State and National performance indicators and makes recommendations for presentation to the Governing Body and staff.
      • Provides orientation education and direction to new personnel, students, and home care aides.
      • Provides education to staff on documentation guidelines, performance improvement for staff from identified deficiencies.
      • Assures documentation quality with regard to regulatory compliance, utilization of services, timeliness and completeness of submitted OASIS assessments, visit notes, supervisory activities and supporting documentation.
      • Adheres to HIPAA regulations, educates staff as needed on relative HIPAA requirements and non-adherence to standards is identified to appropriate supervisor immediately.
      • Participates in staff meetings and in-services, as appropriate; completes annual mandatory in-services and maintains current CPR certification
      • Performs direct patient care as directed and as staffing patterns warrant per nursing practice act scope of practice as needed
      • Assists and supports other staff in completion of job duties as needed or assigned.Reporting Structure:Reports to the Manager, Quality Assurance.Working Environment:Works in home or company office setting. May perform patient care as needed during short staffing.Exposure Risk:High Risk.

        • Graduation from an accredited school of nursing, and currently licensed in the State of Missouri
        • Two years of experience in home health management preferred.
        • Good understanding of Medicare reimbursement guidelines and other third party payors.
        • Possesses good interpersonal relationship and communication skills.
        • Current licensure as a registered nurse in the state(s) in which practicing
        • Requires current state issued driver's license, current motor vehicle insurance coverage and a motor vehicle in working condition.Physical 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.
          • Ability to do extensive bending, lifting and standing on a regular basis.PI177204681

Keywords: AGING WELL HEALTH CARE LLC, St. Louis , Quality Assurance Nurse (RN), Healthcare , Saint Louis, Missouri

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