Brookdale Senior Living

  • Quality Review Nurse

    Job Locations US-IL-Lisle
    Category
    Healthcare
    Requisition Post Information* : External Company URL
    https://www.brookdale.com/en.html
    ID
    2019-26321
    Location : Name
    Brookdale Lisle SNF (IL)
    Location : Address
    1800 Robin Lane
    Location : Location
    US-IL-Lisle
  • Overview

    Every day is an opportunity for our associates to deeply connect with people in a profound and personal way. Our associates are the core of our mission and we know that offering them genuine rewards and heart filling job satisfaction is the key to our success as a company. Here you’ll find opportunities to grow your career at any level whether you have direct contact with resident or support someone who does, and be inspired personally. With over 60,000 associates, there’s a place for you to make a difference in lives of the families we serve throughout our continuum of care.

    Responsibilities

    Supports the efforts of the agency in managing quality of clinical care, utilization, documentation, outcome and process management through education, associate interaction and electronic review of patient records and reporting systems. Training and development of clinical staff in OASIS, coding and documentation competencies are critical components of this role. Responsible for outcome management through implementation of best clinical practices and working within a team environment.

     

    1. Completes the clinical documentation reviews of all clinicians involved in the care of patients in a timely manner as part of the process involved with the electronic documentation system. Timely benchmarks established by the company will be followed. Confers via phone or fax with the Home Health Clinicians as to OASIS inconsistencies or incorrect coding for appropriate corrections to the documentation. Attains approval from the clinician prior to making changes to the OASIS or coding.
    2. Reviews and analyzes the Plan of Care for accuracy, completeness, appropriate content, and appropriate visit utilization. Discusses suggested changes or edits with RN and/or therapist. Attains approval from the clinician prior to making changes within the EMR.
    3. Utilizes available tools and develops training strategies to improve outcomes. Collaborates with Regional, Divisional and Corporate support resources as needed for strategies.
    4. Develops training based on evaluated competencies in documentation and clinical practice, edits from SHP alerts, and SHP reports for specific Outcomes, Adverse Events, and Utilization Reports in conjunction with Director of Professional Services and Regional Director of Operations.
    5. Participates in processes such as Face to Face, Case Conference, verbal orders, and medication changes.
    6. Runs operational and compliance reports weekly and monthly.
    7. Consistently demonstrates sound judgment and communication in the day-to-day operations and interactions with co-workers, management staff, and customers including on-going communication regarding patient care with physician, referral sources, care givers, patient, and community management and associates to facilitate coordination of care.
    8. Participates in the joint interview, hiring, orientation, and performance review process of the clinical care team members and paraprofessional associates as needed.
    9. Provides complex care management and oversight of professional and paraprofessional associates as indicated.
    10. Executes physician’s orders and keeps the physician informed of all pertinent information concerning the patient’s condition in response to treatment. Participates with the care team and documents coordination within the clinical record.
    11. Participates in all agency compliance activities.
    12. Assists and participates in Continuous Quality Improvement Program.
    13. Participates in training specific to OASIS, Coding and documentation. Travel may be required to other agency sites as assigned to provide education, training and working one-on-one.
    14. Adheres to established confidentiality standards as required by Brookdale Healthcare Services and HIPAA concerning community and patient information.
    15. Other duties as assigned.

     

    This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.

    Qualifications

    Education and Experience
    Registered Nurse with three years of experience, of which two years within licensed and certified (Medicare) home health. BSN preferred. Competent in Medicare home health regulations, state home health regulations, documentation requirements, ICD-9 coding, OASIS and PPS. Demonstrates the ability to make appropriate judgments based on sound knowledge of nursing principals, procedures and elements of patient teaching.

     

    Certifications, Licenses, and Other Special Requirements
    OASIS Certification, COS-C or HCS-O preferred, and other coding certification appropriate to which associate will be working. Willingness to complete certifications within 6- 12 months of employment if experienced without credentials. Willingness to complete all assigned on-line training as identified to enhance skill set.

     

    Management/Decision Making
    Applies existing guidelines and procedures to make varied decisions within a department. Uses sound judgment and experience to solve moderately complex problems based on precedent, example, reasonableness or a combination of these.

     

    Knowledge and Skills
    Possesses extensive knowledge of a distinct skill or function and a thorough understanding of the organization and work environment. Has working knowledge of a functional discipline. Extensive clinical knowledge and proficiency in Nursing, Physical, Occupational and Speech/Language Therapy. Demonstrated ability to manage defined systems and processes within the Home Health agency. Basic computer software skills including Microsoft Word and Excel. Ability to address staff, residents and visitors in a courteous and friendly manner as well as accept
    constructive criticism. Ability to respect the privacy of residents and to refrain from discussing their personal situations and problems with others, particularly as it may relate to their health. Ability to communicate with residents of various levels of functioning and various types of personalities. Ability to speak and write English fluently in order converse with residents. Willingness and ability to assist in planning and executing evacuation of residents during emergency situations. Willingness to communicate perceived needs of residents to other skilled staff to assist with addressing their care needs.

     

    Physical Demands and Working Conditions

    • Standing
    • Requires interaction with co-workers, residents or vendors
    • Walking
    • Sitting
    • Occasional weekend, evening or night work if needed to ensure shift coverage.
    • Use hands and fingers to handle or feel
    • Reach with hands and arms
    • Possible exposure to communicable diseases and infections
    • Climb or balance
    • Stoop, kneel, crouch, or crawl
    • Talk or hear
    • Taste or smell
    • Ability to lift: Up to 50 pounds
    • Possible exposure to blood-borne pathogens
    • Possible exposure to various drugs, chemical, infectious, or biological hazards
    • Requires Travel: Occasionally
    • Vision

     

    Brookdale is an equal opportunity employer and a drug-free workplace.

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