Job Code:

Location: lynn

Department: clinical

All Care Division:

Hours: Mon-Fri 8:30am-4:30pm

Shift:

Position Summary:

Clinician who is responsible for Clinical reviews, quality and performance improvement activities and assistance with Clinical staff education / development.

 

AGENCY EXPECTATION OF EMPLOYEE

All Care is committed to Service Excellence, outstanding communication and exceeding the expectations of those we serve, including our patients, our referral sources, those who support our agency and each other. The agency recognizes employees who deliver on this commitment through a formal recognition program. At minimum, 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 necessary skills to work in the home care environment. Each employee is expected to maintain open, honest and appropriate confidential communications with all customer groups in order to foster an effective service environment.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Maintains current knowledge of condition of participation, Medicare and Medicaid.
  • Maintains current knowledge of OASIS including process measures and outcomes.
  • Timely review of Medicare final claims.
  • Completes all Medicare RAPS prior to month’s billing close date.
  • Reviews SOC, recerts and discharge documentation for appropriate ICD-9 coding, HHRG’s and outcomes.
  • Weekly meeting with assigned Team Manager to discuss outstanding documentation issues and problematic clinicians.
  • Attends weekly care co-ordination meeting and facilitates meeting in Manager’s absence.
  • Performs monthly OASIS audit visits.
  • Acts as a resource for clinical staff.
  • Notifies QI Director of problematic/risk areas along with a solution to prevent reoccurrence.
  • Completes incident reports for non-compliance of Agency policies and procedures.
  • Administers Manitou’s
  • On-call responsibilities to meet the agency’s need.
  • All other tasks as assigned by Supervisor.

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. Must be familiar with MS Word, Outlook and Excel.

 

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 regularly lift and/or move 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.