RN / Home Healthcare Nursing Job in Summersville, West Virginia / Home Health Care
Company: Kindred at Home
Location: Summersville
Posted on: August 7, 2022
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Job Description:
I believe that better care begins at home. Compassionate care,
uncompromising service and clinical excellence thats what our
patients have come to expect from our clinicians. Kindred at Home,
a division of Kindred Healthcare Inc., is the nations leading
provider of comprehensive home health, hospice, and non-medical
home care services.
Kindred at Home, and its affiliates, 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.
I believe my work is my calling.
As a Home Health Quality RN Manager, 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. Identifies clinical problem areas and
documents deficiency trends in a proactive approach. Educates
administrative and clinical associate staff in the correction of
these deficiencies
Assist with quality improvement and Medicare compliance training
program. Utilizes Kindred Health Services approved reference
materials to resolve inadequacies
Communicate with the Area Education Specialist regarding identified
trends of deficiencies with Medicare Conditions of Participation,
clinical care, coordination of care, and documentation for the
purposes of requiring more extensive education or action of
clinical staff
In accordance with the Branch Director, monitor the receipt of
Medicare denials, Billing Compliance held claims, and other payer
denial notices. Assess the validity of these denials, and responds
with additional information. Inform the Branch Director and Branch
staff of noticeable trends or relevant issues
In accordance with the Branch Director, prepare and file general
appeals on a timely basis. Attend fair hearings as necessary.
Collaborate with the Clinical Leadership and clinical associate
staff in resolving complex clinical issues
Participate in the initial orientation of the clinical associate
staff regarding Medicare Conditions of Participation and relevant
requirements for care and documentation and provides education
during the orientation in the timeliness of paperwork and flow of
OASIS
Collaborate with branch Clinical Leadership to analyze Performance
Improvement trends in the delivery of care. Keep up with the
performance indicators and monitors the Performance Improvement
plan for the branch. Essential in driving performance measures in
the branch
Facilitate initiating and gathering the competed CRR tools on a
monthly basis and communicates to the Area Education or Area
Clinical Specialist when task is completed
Serve as the Chairperson of the Quality Assurance Committee.
Conducts the committees quarterly meetings utilizing the
Performance Improvement Recommended Timeline as a guide and
coordinates and compiles the data for the meetings
Review OASIS documents for accuracy and completeness prior to
locking and submitting data electronically. Explain and mentor
clinicians and staff on COPs 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 Kindred Healthcare reports
such as Projected vs Actual, PPS Unbilled and Post Billing
Adjustment, to identify trends. Collaborate with the Manager
Clinical Practice and other clinical and/or branch leadership on
clinical staff performance. Provide input to the clinical staff
performance evaluation period
Adhere to and participate in Companys mandatory HIPAA privacy
program/practices and Business Ethics and Compliance
programs/practices and Medicare Billing Requirements
program/practices. Review and adhere to all Company policies and
procedures and the Employee Handbook. Participates in special
projects and performs other duties as assigned
Bachelors degree in Nursing or the equivalent plus
N. Licensure in the state(s) of practice
Three to five years nursing experience, including two years of home
healthcare experience within the past five years
Prior ICD-9/10 coding experience is highly desirable
Keywords: Kindred at Home, Roanoke , RN / Home Healthcare Nursing Job in Summersville, West Virginia / Home Health Care, Healthcare , Summersville, Virginia
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