RN Manager Of Clinical Practice And Quality Assurance (57954)

Gentiva Health Services, Inc. Bellevue , WA 98009

Posted 1 week ago

I believe that better care begins at home.

Compassionate care, uncompromising service and clinical excellence that's what our patients have come to expect from our clinicians. Kindred at Home, a division of Kindred Healthcare Inc., is the nation's leading provider of comprehensive home health, hospice, and non-medical home care services.

Kindred at Home, and its affiliates, including Gentiva, delivers compassionate, high-quality care to patients and clients in their homes or places of residence, including non-medical personal assistance, skilled nursing and rehabilitation and hospice and palliative care. Our caregivers focus on each unique patient to deliver the appropriate care and emotional support to our patients and their families.

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.

  • Identify clinical problem areas and documents deficiency trends in a proactive approach.

  • Educate administrative and clinical associate staff in the correction of these deficiencies.

  • Assist with quality improvement and Medicare compliance training program. Utilize Gentiva Health Services approved reference materials to resolve inadequacies.

  • Review OASIS documents for accuracy and completeness prior to locking and submitting data electronically. Explain and mentor clinicians and staff on COP's and on billable skilled visits.

  • Educate and mentor clinicians one on one (in person or over the phone) regarding concerns, questions, accuracy of OASIS data, and other related documents, that are being reviewed.

  • Facilitate the ICD-9/10 coding of the Plan of Treatment based on OASIS data and patient assessment documentation that is assessed at the bedside.

  • Collaborate with Branch leadership to ensure effective and efficient episodic management, utilizing Gentiva Health Services reports such as Projected vs. Actual, PPS Unbilled and Post Billing Adjustment, to identify trends.

Required Skills

Qualification:

  • Current Registered Nurse

  • Minimum of three years clinical home care experience

  • Minimum of one year in a clinical management role

  • Knowledge of state and federal home health agency regulations/Conditions of Participation and Compliance standards and regulations

  • Proven track record of clinical management, education and management of healthcare staff

  • Outstanding leadership and managerial skills

  • Knowledge of clinical policies and procedures and ability to implement

  • OASIS certified or will be required to obtain OASIS certification within 1 year of hire as a MCP

  • Good organization, communication, human relations skills and reliable transportation

  • Must possess the ability to lead and manage clinicians and office staff for successful patient outcomes and clinical and branch performance

Required Experience

keywords: RN, Registered Nurse, Nurse, nursing, homecare, home care, home health, home healthcare, OASIS, RN case manager, Medicare, visit nurse, admission nurse, case management, r.n., rn, homecare manager, home care manager, clinical director, clinical administrator, clinical supervisor, patient care manager, director of nursing, DON, DOCS, Field Case Manager, director of clinical services, RN manager, registered nurse manager, RN supervisor, Registered Nurse Supervisor, nurse management, nurse manager, RN director, Registered Nurse Director, QA RN, QA Nurse, Quality Assurance Nurse, Quality Assurance RN, OASIS C, OASIS-C, HCS-D, HCSD, HCS D, Home Care Coding Specialist Diagnosis, Homecare Coding Specialist Diagnosis, COSC, COS-C, Certificate for OASIS Specialist Clinical, ICD 9, ICD 10, audit, Medical Coding ~MON~

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or national origin.


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RN Manager Of Clinical Practice And Quality Assurance (57954)

Gentiva Health Services, Inc.