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Description

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Summary:

The RN Quality Assurance Specialist will oversee the clinical documentation of the direct care clinical staff to ensure it is compliant with Medicare, Medicaid/state/federal regulations, and agency policies and guidelines; works closely with Performance

Improvement (PI) coordinator and agency educator to identify areas of education as needed; provides guidance and education to field staff regarding accurate, thorough documentation; ensures timely submission and approval of the patient’s plan of care and provider orders to ensure compliance with state and federal regulations.

Responsibilities:

1. Demonstrates working knowledge of regulatory and provider guideline, updating knowledge base continuously through self study and in service attendance. Maintains awareness of current payor provider agreements in order to complete 485 and OASIS appropriately.

2. Assesses and interprets patient data as needed to provide guidance to Case Managers on patient needs relative to his/her age and conditions. Consults with patient case managers/team leaders for care coordination as necessary.

3. Promote and maintains interpersonal communication with all team members, clinicians and physicians.

4. Demonstrates ability to educate, develop and stimulate the professional growth and development of staff members. Serves as clinical resource to home health staff as well as physicians and their office staff as related to home care services, orders and diagnoses.

5. Identifies staff educational needs to ensure safe and effective patient clinical management. Recommends, plans and or participates in staff development programs for employees.

6. Ensures that all patient OASIS assessments are submitted by staff and that they are complete and compliant with Medicare/Medicaid/state/federal regulations and agency policy.

7. Responsible for reviewing for patient assessments for completeness, locking and submitting the assessment per regulatory guidelines. This includes, but not limited to: coding and diagnoses, patient short and long term goals with end points for all services, orders/goals for all disciplines, and notifies the clinical staff assessment revisions as needed.

8. Manages the implementation of nursing process to ensure quality of patient care delivery and monitors outcomes of care as appropriate.

9. Participates in employee educational programs to improve the quality of the patient plan of care and OASIS assessments.

10. Meets or exceeds daily assessment review productivity.

11. Works with the Quality Manager and Director in the development and implementation of departmental goals and standards.

12. Audits patient records for completeness of documentation and adherence with agency, organizational, state and federal regulations and payor requirements.

13. Provides for quality review (QA) related education and assessment review with new staff during the onboarding and orientation, or as indicated

14. Provides for other duties or tasks as assigned.

Other Information

Other information:

Education Requirements:

• Bachelor’s degree in Nursing (BSN) from a state accredited school of professional nursing

Licensure/Certification Requirements:

• Current RN license to practice in NC

• Must be Oasis Certified (HCS-O,COS-C) or obtain certification within one (1) year of employment

• Adult CPR

Professional Experience Requirements:

• If a Bachelor's degree: requires four (4) years of related experience and/or training.

• A minimum of two (2) years of experience in Home Health

Knowledge/Skills/and Abilities Requirements:

• Must be professional with effective critical thinking and problem solving skills.

Strong interpersonal and communication skills for cross department collaboration.

Strong team player with high attention to detail that can adapt easily to continuous change.

Job Details

Legal Employer: STATE

Entity: UNC Medical Center

Organization Unit: UNCH Home Health Administration

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $30.73 - $44.18 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Hybrid

Work Schedule: Day Job

Location of Job: US:NC: Chapel Hill

Exempt From Overtime: Exempt: Yes

This is a State position employed by UNC Health Care System with UNC Health benefits. If, however, you are presently an employee of another North Carolina agency and currently participate in TSERS or the ORP, you will be eligible to continue participating in those plans at UNC Health.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [email protected] if you need a reasonable accommodation to search and/or to apply for a career opportunity.

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.