Quality Reviewer

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🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

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CentraState Healthcare System

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

CentraState Healthcare System is a private, not-for-profit health organization dedicated to excellence, offering the full circle of health and wellness for the community. The medical center became a teaching hospital in 2005 with the launch of its Family Medicine Residency Program in conjunction with the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. In 2010, the hospital received Magnet status for nursing excellence by the American Nurses Credentialing Center (ANCC) of the American Nurses Association.

📋 Description

• Provide timely review of SOC, ROC, and recertification documentation using the CRC assessment tool • Provide clinical feedback on OASIS accuracy and plans of care • Code charts based on primary and secondary reasons for home care • Review and advance 485 documentation in a timely manner • Use home care information systems and decision support software • Oversee resource utilization for Medicare clients and recommend resources matching patient needs • Provide feedback and education to clinical and intake staff regarding OASIS and documentation deficits • Notify managers of staff non-compliance and identify trends requiring staff education • Develop and implement individual and team educational sessions • Participate in the agency’s QAPI program and performance improvement projects • Cross-train, accept assignments supporting the agency, and assist with agency business growth • Attend continuing education related to OASIS review and ICD-10 coding

🎯 Requirements

• Current NJ RN or PT License • Three Years of Certified Home Care experience • Thorough knowledge of home care regulations and COPs • OASIS and Coding certification desirable

🏖️ Benefits

• Medical, Dental, Vision, Prescription Coverage (22.5 hours per week or above for full-time and part-time team members) • Life & AD&D Insurance • Short-Term and Long-Term Disability (with options to supplement) • 403(b) Retirement Plan: Employer match, additional non-elective contribution • PTO & Paid Sick Leave • Tuition Assistance, Advancement & Academic Advising • Parental, Adoption, Surrogacy Leave • Backup and On-Site Childcare • Well-Being Rewards • Employee Assistance Program (EAP) • Fertility Benefits, Healthy Pregnancy Program • Flexible Spending & Commuter Accounts • Pet, Home & Auto, Identity Theft and Legal Insurance