Quality Review Coordinator (RN, Oasis, Utilization) - HomeCare
Company: Hartford HealthCare
Posted on: September 17, 2023
Description Job Schedule: Full Time Standard Hours: 40 Job
Shift: Shift 1 Shift Details: Work where every moment matters.
Every day, over 30,000 Hartford HealthCare colleagues come to work
with one thing in common: Pride in what we do, knowing every moment
matters here. We invite you to become part of Connecticut's most
comprehensive healthcare network as a Quality Review Coordinator.
Hartford HealthCare at Home, the largest provider of homecare
services in Connecticut, has been fulfilling our mission for more
than 115 years. Our Person-Centered Care Model allows our employees
to learn and grow within our organization, all while providing
integrated support to the patient. As part of Hartford HealthCare,
we leverage cutting edge technology to provide quality care in our
client's home. Most importantly, our employees are appreciated for
the real differences they make in both the lives of their clients
and their clients' families. Job Summary:
Participates in improving the overall integrity of clinical
documentation. Reviews clinical data upon admission,
recertification, transfer, resumption of care and discharge for
documentation consistency with Plan of Care, acuity level, service
appropriation and completeness. Responsible for accurate, timely,
and proficient completion of clinical and reimbursement
documentation. Utilizes software applications as a tool to screen
documentation accuracy. Independently makes corrections, where
appropriate, in collaboration with the clinical case manager per
agency policy. Responsible for the assignment of appropriate
diagnosis code(s), as well as assuring accuracy. Provides direction
to the clinical staff as it relates to clinical documentation.
Collects and summarizes data related to inconsistencies and
designs, develops, and implements interventions and supporting
reference materials/modules to address. Supports Agency
preparedness for oversight/accreditation review.
--- Performs qualitative, concurrent review of clinical
documentation upon admission, recertification, transfer, resumption
of care, and discharge documentation and associated physician
orders and additional routine audits as directed by the
--- Reviews all clinical documentation, with a focus on data
accuracy and consistency. Upon discussion/collaboration with
clinicians, amends documents as needed to assure consistency and
accuracy of information.
--- Assesses the overall Plan of Care (if indicated, includes Home
Health Aide Plan of Care) to determine consistency with clinical
documentation. Ensures consistency of HHRG assignment with the
documented Plan of Care, as well as service appropriation.
--- Apply coding principles accurately, and in accordance with
documented patient acuity levels.
--- Reviews medication profiles and physician orders (signing as
indicated) assuring accuracy and completeness.
--- Provides recommendations to the clinical staff as it relates to
accurate and timely clinical documentation.
--- Identifies and communicates significant documentation or
clinical concerns to department manager, or designee. As directed
by the Manager, collects data from routine audits like quarterly
record and adverse event reviews, as well as targeted audits
identified. Summarizes and analyzes data and develops reports as
--- Collects and summarizes data related to documentation
--- Problem solves and coordinates feedback regarding documentation
inconsistencies with field staff and Clinical Managers, as
indicated. Is able to connect feedback with regulatory
requirements. Interface may take the form of multidisciplinary case
conference, telephonic discussion, or one-on-one interaction.
--- Participates in training/instruction from formulated modules to
affect and stabilize inconsistencies identified through the
collection, analysis, and trending of concurrent review data.
--- Partners with Performance Improvement and Education Departments
to set priorities and to design and implement educational
activities for clinical staff.
--- Applies performance improvement methodology to evaluate the
efficacy of designed interventions. Tracks the impact of
improvement plans in targeted areas over time, communicating
frequently with clinical staff.
--- Collects and summarizes data related to documentation
inconsistencies and untimely processing. Produces reports, as
appropriate and requested, to illustrate findings with
recommendations for improvement.Qualifications Education &
Training: Graduate of a National League of nursing accredited
program or state approved Practical Nurse education program.
License/Certification: Current Connecticut RN or LPN license or
eligible for RN or LPN License in the State of Connecticut.
Experience: Three (3) years of clinical nursing experience, at
least one (1) year of which is in Home Health Care.
--- Demonstrated excellence in nursing practice.
--- Well-developed interpersonal skills, self-motivated, creative,
and good written and oral communication skills.
--- Ability to deal effectively with stress and multiple competing
--- Exhibits leadership and ability to work with clinical
--- Knowledge of OASIS assessment and coding preferred.
--- Knowledge of licensure, regulatory and governmental
requirements, CHAP accreditation standards, Agency policies,
practices and protocols and other third party rules.
--- Computer proficient with knowledge of basic office
Other: Valid motor vehicle operator's license, reliable personal
automobile during business hours, and active automobile insurance
coverage in accordance with Agency policy. We take great care of
careers. With locations around the state, Hartford HealthCare
offers exciting opportunities for career development and growth.
Here, you are part of an organization on the cutting edge - helping
to bring new technologies, breakthrough treatments and community
education to countless men, women and children. We know that a
thriving organization starts with thriving employees we provide a
competitive benefits program designed to ensure work/life balance.
Every moment matters. And this is your moment.
Keywords: Hartford HealthCare, Middletown , Quality Review Coordinator (RN, Oasis, Utilization) - HomeCare, Healthcare , Middletown, Connecticut
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