Posted: Friday, May 12, 2017 9:18 AM
As a RN Manager of Clinical Practice and Quality Assurance, you will:Review all Medicare and other episodic payers' clinical records at the local level to assure appropriate documentation for reimbursement. This review includes verification of appropriate documentation, quality of care provided, visits utilization, appropriate contacts with physicians, adherence to the care plan, and evidence of communication between disciplines.Oversee the maintenance of clinical records and files to comply with Conditions of Participation (COPs), using measurements, as licensure, certification, and accreditation results.Audit charts for clinical oversight and compliance and adherence to the Medicare guidelines.Manage clinical activities, including patient assessments, care plan development, service level determination, on-site field visits, and the implementation/coordination/maintenance/evaluation of care plans.Be responsible for direct supervision of clinical staff. Participate in the recruitment, interviewing, selection, and orientation of team members; evaluate their performance relative to job goals/requirements; coach staff and recommends in-service education programs and ensure adherence to internal policies/standards. Manage the assignment of clinical associates.Ensure service quality and participates in care coordination to ensure proper communication between caregivers, patients, referral sources and payers. Discuss operational issues, update staff on new/changed regulations and review records/documentation to ensure regulatory and in-house compliance.Have oversight of clinical integrity of appropriate documentation, quality of care provided, visits utilization, appropriate contacts with physicians, adherence to the care plan, and evidence of communication between disciplines.Be accountable for financial responsibility related to budget goals through utilization, documentation, providing appropriate and accurate patient care, case mix weight, and appropriate utilization of delivery of patient care.Conduct and/or delegate the assessment and reassessment of patients, including updating of care plans and interpreting patient needs, while adhering to Company, physician, and/or health facility procedures/policies.Coordinate communication between team members/attending physicians/caregivers to ensure the appropriateness of care and outcome planning and ensures compliance through review of documentation and care coordination activities.Participate in performance improvement activities, maintain ongoing clinical knowledge through internal/external training programs, provide interpretation of knowledge and direction to staff.Required Skills:Qualification:Current Registered NurseMinimum of three years clinical home care experienceMinimum of one year in a clinical management roleKnowledge of state and federal home health agency regulations/Conditions of Participation and Compliance standards and regulationsProven track record of clinical management, education and management of healthcare staffOutstanding leadership and managerial skillsKnowledge of clinical policies and procedures and ability to implementOASIS certified or will be required to obtain OASIS certification within 1 year of hire as a MCPGood organization, communication, human relations skills and reliable transportationMust possess the ability to lead and manage clinicians and office staff for successful patient outcomes and clinical and branch performanceAll qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or national origin.
• Location: Columbia/Jeff City
• Post ID: 25825403 columbiamo