Capleo Global LLC - Newport Beach, CA
posted 4 months ago
The Quality Review Nurse is a professional role for a licensed vocational nurse (LVN) who will be responsible for ensuring the integrity and consistency of OASIS documentation and assessment processes. This position is critical in maintaining compliance with federal and state regulations, as well as organizational policies. The Quality Review Nurse will conduct thorough analyses of OASIS assessments, ensuring that they are appropriate, complete, and compliant. This includes a detailed review of ICD-10 coding and sequencing as it pertains to the patient's medical condition and any co-morbidities. In this role, the nurse will prospectively review all OASIS assessments, utilizing OASIS variation or alert reports to identify any discrepancies or issues. The Quality Review Nurse will also assess visit utilization to ensure adherence to care guidelines and report any potential financial losses or underutilization to the clinical manager or designee. Additionally, the nurse will notify organizational leadership of any problematic trends identified during the OASIS review process and collaborate with managers to address these trends, which may impact the agency's outcome and process measures. The position requires the nurse to perform inter-rater reliability visits with clinical staff and to carry out other duties as assigned. This role is essential for maintaining high standards of care and ensuring that documentation practices meet regulatory requirements.