Position Title: QI
Nurse
Clinical Job Code # CL8
Position Department: Clinical
All Care Division: VNA
Location: Lynn, MA
HOURS/SCHEDULE
Per Diem
Shift: Days
Position Summary: RN who is responsible for Clinical reviews, quality and performance improvement activities and assistance with Clinical staff education / development
AGENCY EXPECTATION OF EMPLOYEE
All Care expects each employee to maintain a positive, respectful attitude, to demonstrate flexible and efficient time management, to meet departmental productivity standards, while keeping current the clinical abilities to work in the home care environment. Each employee is expected to maintain open, honest and appropriately confidential communications with all customer groups in order to foster an effective service environment.
ESSENTIAL DUTIES/RESPONSIBILITIES
Maintains current knowledge of Medicare / Medicaid commercial insurance regulations and criteria for coverage.
Maintains current knowledge of OASIS / OBQI, and OBQM processes.
Identifies problem areas / risk factors.
Acts as a resource for Clinical staff
Vacation coverage for clinical management as needed.
Maintains knowledge of Medicare appeals process (488's, post payment reviews, reconsideration and ALJ process).
Review clinical documentation in response to Fiscal Intermediary requests.
Agency Hepatitis and Mantoux Clinics.
Accepts other assignments as designated by the Q.I. Director.
Performs monthly OASIS audit visits.
All other responsibilities as assigned by supervisor.
On Call responsibilities to meet the agency's need
Professionalism
Complies with infection control and safety measures in accordance with the agency's policies and procedures.
Maintains high level of clinical expertise necessary to meet the needs of the client population and recognizes need for ongoing professional education and development within the agency and in the community.
Recognizes personal strengths and weaknesses, independently seeks out appropriate resources.
Shares professional experience, skills and knowledge with other staff members.
Assists in orientation of new staff as requested by supervisor or team leader.
Participates in the Agency's Quality Improvement and Peer Review Programs.
Acts in a consultative manner and serves as clinical resource in specialty area with Agency clinicians.
QUALIFICATIONS
Experience, Education and Licensure
Graduate of an NLN accredited school of nursing, preferable
a B.S.N. or B.S. program. Knowledge of rules and regulations
of participation in a Medicare certified home health agency
is preferred. Possesses a sound clinical knowledge and
practice and has the ability to problem solve. Current
Registered Nursing Licensure in state where client services
are being rendered, current driver's license.
Language Skills
Ability to read, analyzes and interpret general business
periodicals, professional journals, technical procedures, or
governmental regulations. Ability to write reports, business
correspondence, and procedure manuals. Ability to
effectively present information and respond to questions
from groups of managers, clients, customers, and the general
public
AMERICANS WITH DISABILITY SPECIFICATIONS
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
Work Environment
Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time. The noise level in the work environment is usually moderate.
The employee is expected to act as a role model and to adhere to all Agency policies.
Contact Information:
Please contact Laurie Proulx, All Care Recruiter
All Care, 2 State Street, Lynn, MA 01901
Email: lproulx@allcarevna.org
Phone: 781-244-1150
Fax: 781-244-1058
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