Home
/
Comprehensive
/
Quality Review Specialist -RN, PT, OT or ST (Compact License Required)
Quality Review Specialist -RN, PT, OT or ST (Compact License Required)-April 2024
Louisville
Apr 2, 2026
About Quality Review Specialist -RN, PT, OT or ST (Compact License Required)

  Summary

  Responsible for the timely review of plan of care and OASIS time points in the electronic medical record to ensure accuracy of OASIS items, documentation, and utilization for quality and outcome management through clinician collaboration and implementation of best clinical practices. Responsible for identifying opportunities for improved OASIS accuracy and reporting these to OASIS clinical staff during scheduled staff meetings.

  Responsibilities

  Thoroughly reviews the medical record as part of the OASIS review process and recommend the most accurate codes, adhering to official OASIS guidelines as approved by the Centers of Medicare and Medicaid Services (CMS). Reviews plan of care; recommends edits to clinician and makes edits to the plan of care based on updated provider orders Consistently engages directly with clinicians to improve accuracy of OASIS assessments, ensure proper development of the plan of care relevant to the primary focus of care and the patient assessment, and assure clinically appropriate discharges. Assesses clinical documentation to ensure that it supports the recommended OASIS and POC changes. Consults the clinician for clarification, via electronic alerts, when conflicting or ambiguous documentation is present, and abides by the clinician's acceptance or declination of changes. In the event a clinician's declination will violate an OASIS guideline, follows the escalation process. Provides OASIS education to clinicians when opportunities arise (e.g., provide pertinent official OASIS guidelines or conventions when the clinician questions a change recommendation). Follows workflow/process exactly as outlined in training material without deviation. Meets or exceeds productivity expectations while maintaining excellent quality of reviews and the upmost customer service Participates in staff meetings and educational sessions. Maintains accurate and timely review of OASIS time points and all related interdisciplinary documentation via the workflow in the electronic medical record (EMR) for timely OASIS locks and submission to the Centers for Medicare and Medicaid (CMS). Participates in conferences or teleconferences with the Clinical Director, Patient Care Manager, and/or home health clinicians regarding identified OASIS, utilization, or plan of care inconsistencies. Utilizes available tools and develops training strategies to improve outcomes. Collaborates with Regional, Divisional, and Home Office support resources as needed for strategies. Develops and implements training based on evaluated competencies in documentation and clinical practice, edits from Strategic Healthcare Programs (SHP) alerts, and SHP reports for specific outcomes, adverse events, and utilization reports in conjunction with the OASIS Analyst, Clinical Director (CD), Executive Director (ED), or PI Coordinator. Consistently demonstrates sound judgment and professional communication in the day-to-day operations and interactions with co-workers and customers to facilitate coordination of care. Collaborates with regional PI coordinator & agency to facilitate initiatives to improve quality outcomes and agency ratings. Completes all required education timely. Adheres to established confidentiality standards as required by LHC and HIPAA concerning community and patient information. Identifies educational trends for agency and/or per clinician and discusses with Clinical Director and Quality Review Supervisor to further train/educate staff and improve OASIS accuracy. Reports to supervisor and operational leadership any continued lack of improvement or engagement from clinicians. QR Specialist may be required to relocate to a nearby office and perform PCM workflow occasionally. QR specialist will continue to participate in on-call rotation for their originating agency if they were in the on-call rotation prior to QR role. Performs other duties as assigned timely and effectively.Education and Experience

  Current CPR certification required Current Driver's License, vehicle insurance, and access to a dependable vehicle or public transportation 1 year Home Health experience as RN, PT, ST or OT Current RN. PT, ST, or OT licensure in state of practice Current COS-C or completion within 90 days of position effective dateSkill Requirements

  Ability to analyze OASIS data at a high level, and to accurately interpret and apply current OASIS guidelines, Conditions of Participation, and PPS guidelines to find opportunities for training and development. Effective verbal and written communication skills Strong computer skills with proven ability to use MS Office applications, OASIS review software, and clinical documentation software as well as reports available in these programs. Exceptional organizational skillsCompany Overview

  LHC Group is committed to a culture of diversity, equity and inclusion and is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to r ace, color, r eligion, s ex, s exual orientation, gender identity, national origin, disability, status as a protected veteran, or any legally other protected characteristic.

  LHC Group Inc Home Office a part of LHC Group family of providers - the preferred post-acute care partner for hospitals, physicians, and families nationwide. We deliver high-quality, cost-effective care that supports our patients when and where they need it. From our home health, hospice, and community-based services to inpatient care at our clinics and hospitals, our mission is to reach more patients and families with effective and efficient healthcare. More hospitals, physicians, and families choose LHC Group because we are united by a single shared purpose: It's all about helping people.

  Equal Opportunity Employer - vets, disability.

Comments
Welcome to zdrecruit comments! Please keep conversations courteous and on-topic. To fosterproductive and respectful conversations, you may see comments from our Community Managers.
Sign up to post
Sort by
Show More Comments
SIMILAR JOBS
Phlebotomist
Description Want to Expand your career-development potential, your ability to help donors and patients, and your access to professional opportunities? We’re growing fast. [You can, too!] There are so
Dispatcher
Dispatcher Location19 Natalie Way Plymouth, Massachusetts 02360 USPhone NumberCategoriesOperation SupportReq IDJR1372 Dispatcher (Open) First for a reasonFirst Student is the largest school transport
Creative Lead / Designer II
Company Summary DISH, an EchoStar Company, is a Fortune 250 that is reimagining the future of connectivity. For over 40 years, we’ve been challenging the status quo and evolving our company to antici
Intermediate Compliance Specialist (Hybrid Work Option)
36718BR Requisition ID: 36718BR Business Unit: COR Job Description: CDM Smith is seeking an Intermediate Compliance Specialist to join our Corporate Compliance Team. This individual performs basic to
Health Technician (Dietetic)
Summary The Dayton Veterans Affairs Medical Center (VAMC) is recruiting for a Health Technician. The Health Technician will function with in Nutrition and Food Services. The primary purpose of the po
Pharmacy Technician
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced
Senior Member of Technical Staff (JoinOCI-SDE)
Job Description We are seeking a strong engineer to join our team which is focused on building and maintaining a scalable software control platform for Compute Infrastructure. Major focus areas of so
Water / Wastewater Engineering Manager 6 - US Hybrid
Water / Wastewater Engineering Manager 6 - US Hybrid Date: Jan 23, 2024 Location: US Company: Black & Veatch Family of Companies Together, we own our company, our future, and our shared success.
Hotel Laundry Attendant
Req ID: 431582 Address: 7101 W. Sundust Rd Chandler, AZ, 85226 Welcome to Love’s! * * Where People are the Heart of Our Success * * Hotel Laundry Attendant Laundry Attendants are expected to maintain
L2 Customer Technical Support Analyst - MICROS - Simphony/Ebusiness
Job Description L2 Customer Technical Support Analyst - MICROS - Simphony/Ebusiness Location: Orlando, FL or Columbia, MD highly preferred No visa sponsorship is available for this position. As a mem
Copyright 2023-2026 - www.zdrecruit.com All Rights Reserved