RN Quality Review Home Health

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule:

PRN

Shift:

Day (United States of America)

Address:

480 W CENTRAL PKWY

City:

ALTAMONTE SPRINGS

State:

Florida

Postal Code:

32714

Job Description:

Evaluates visits per episode to ensure optimal utilization and achieve the best clinical outcomes and efficient use of resources. Analyzes utilization data to ensure visits align with episode utilization guidelines and best practices for clinical outcomes. Develops and revises utilization policies and practices based on past analysis to improve resource use. Collaborates with colleagues and field clinicians to achieve strategic goals, top decile outcomes, and patient satisfaction. Mentors colleagues and encourages the implementation of best practice guidelines. Determines patient risk for rehospitalization and appropriate care pathways. Develops and implements individualized care plans, including visit frequency and spacing. Identifies appropriate services to meet clinical and fiduciary outcomes and obtain necessary physician orders. Handles escalated clinical authorizations and denials, prioritizing timelines and limits. Ensures compliance with payor and legal regulations and maintain accreditation readiness through record review and case conferencing. Provides support, acts as a role model, and mentors colleagues to maximize professional, clinical, and operational performance. Demonstrates effective, independent judgment in planning and performing activities to achieve desired outcomes. Other duties as assigned.Knowledge, Skills, and Abilities:
• Home Care Experience [Required]
• OASIS Experience [Required]
• PDGM Experience [Required]
• Knowledge and compliance with all local, state, federal, and other regulatory agencies [Required]
• Knowledge of home care reimbursement methodologies, including but not limited to: Medicare, Medicaid, Managed Care, Private Insurances, and Self Pay [Required]
• A high level of multitasking, organization, and proactive communication skills are necessary [Required]
• Problem-solving abilities [Required]
• Positive interpersonal communication skills [Required]
• Must be able to use a high level of abstract reasoning to assess patients, evaluate interventions, and revise the plan of care according to patient outcomes [Required]
• Must possess sound judgment and critical thinking skills [Required]
• Basic computer skills required [Required]
• Demonstrate proficiency in the current electronic medical record systems [Required]
• Must be able to manage multiple details, tasks, and decision-making abilities under busy and stressful working conditions [Required]

Education:
• Associate's of Nursing [Required]
• Bachelor's of Nursing [Preferred]

Field of Study:
• N/A

Work Experience:
• 2+ of experience in management position. [Preferred]
• 3+ of experience in home health [Preferred]

Additional Information:
• N/A

Licenses and Certifications:
• Registered Nurse (RN) [Required]
• Certified for Oasis Specialist-Clinical (COSC) [Preferred]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements - https://tinyurl.com/2vvwrzem

Pay Range:

$31.53 - $52.24

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.