Quality Assurance Nurse Specialist

24 hours ago


Jackson, Mississippi, United States Careline Health Group Full time
Quality Assurance Nurse Job Description

Careline Health Group is seeking a highly skilled Quality Assurance Nurse to join our team. As a Quality Assurance Nurse, you will play a critical role in ensuring the clinical integrity and regulatory compliance of our organization.

Key Responsibilities:

  • Develop and implement quality initiatives and improvement plans to promote regulatory compliance and clinical excellence.
  • Conduct thorough reviews of Start of Care (SOC) assessments to ensure accuracy and completeness.
  • Process re-certifications, death visits, and add orders in a timely and efficient manner, adhering to hospice regulations and guidelines.
  • Assist in tracking and ensuring timely billing and meeting regulatory guidelines.
  • Audit medical records to ensure compliance with regulatory standards.
  • Manage workflow, identify problematic sequencing, and provide solutions to avoid impact on patient care activities.
  • Ensure clinical notes indicate continuing communication and coordination of services with the physician, other staff, and disciplines.
  • Write orders to ensure staff are available for end-of-life care.
  • Assist in the development and design of the QAPI program.

Requirements:

  • Graduate of an accredited Diploma, Associate, or Baccalaureate School of Nursing.
  • Current State License as a Registered Nurse.
  • ICD10 coding certification preferred and required within one year of hire.
  • 3 years of healthcare management and 2 years of experience in hospice care.
  • Demonstrated proven decision-making and financial management skills.
  • Exhibits working knowledge of regulations and reimbursement in home health care as well as proven leadership abilities in staff education.
  • Demonstrates skill in nursing practice, ability to cope with ill, disabled, terminal patients, family emotional stress, and tolerance of individual lifestyles.
  • Requires demonstrated interpersonal skills with the ability to communicate effectively.
  • Current and valid Driver's License.
  • Reliable transportation and valid automobile insurance coverage.

Desired Qualifications:

  • BA/BSN preferred.
  • Quality assurance experience preferred.
  • Familiarity with Home Care Home Base (HCHB).

Location:

Home Office: 801 Rosehill Road, Jackson, MI 49208.

Hours:

Remote Office Hours: 8:00 am - 5:00 pm, Monday through Friday.

Weekend Rotation:

Background Screening:

Careline Health Group conducts a background screening upon acceptance of a contingent job offer. Background screening is completed by a third-party administrator, the Michigan Long-Term Care Partnership, and is performed in compliance with the Fair Credit Report Act.

Reasonable Accommodations:

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.

Please contact us to request accommodation.

Equal Opportunity Employer:

Careline Health Group is an equal opportunity employer.



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