Registered Nurse responsible for ensuring regulatory compliance and continuous performance improvement in home health. Duties include appeals preparation, grievance tracking, patient satisfaction analysis, competency evaluations, clinical record reviews, OASIS data collection, quality metrics analysis, survey readiness, and EMR use to support compliance and improve patient outcomes.
Job Description:
The Position: Quality Management Nurse.
Schedule: Monday - Friday 8:30 am - 5:00 pm
The Quality Management Nurse is a Registered Professional Nurse who will ensure, regulatory compliance and continuous performance improvement. Responsibilities include appeals preparation, grievance tracking, patient satisfaction analysis, and competency evaluations. The ideal candidate demonstrates professionalism, attention to detail, and a commitment to excellence in patient care and staff support.
What we offer:
- Comprehensive benefits including, medical, dental, and vision Insurance.
- $10,000 Tuition Reimbursement.
- 401K plan with company match.
- Robust time off includes 4 weeks of vacation, 5 personal days, and 8 sick days per year.
- Supportive Management team.
- Office-Based Role / day hours.
What we ask for:
- NYS RN License.
- Strong knowledge of CHHA regulations, including federal, state, and Department of Health (DOH) requirements.
- Demonstrated understanding of Medicare Conditions of Participation (CoPs) for home health, including compliance with documentation, visit frequency, and billing requirements.
- Experience conducting clinical record reviews to ensure accuracy, completeness, and compliance with regulatory standards.
- Familiarity with Outcome and Assessment Information Set (OASIS) data collection and its impact on quality reporting and reimbursement.
- Proven ability to analyze quality metrics, identify trends, and implement corrective action plans.
- Prior involvement in survey readiness, audits, or responses to regulatory bodies (e.g., OMIG, CMS, DOH).
- Strong communication skills with the ability to collaborate across clinical, administrative, and operational teams to improve patient outcomes and compliance.
- Proficiency in using Electronic Medical Records (EMR) systems, such as HCHB or similar platforms.
Americare is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee based on race, color, sex, gender, pregnancy, religion, age, creed, marital and partnership status, national origin, ancestry, alienage, past or present physical or mental disability, genetic information, sexual orientation, gender identity, affectional preference, veteran or military status or citizenship status, or any other legally recognized protected basis under federal, state, or local law.
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