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RN Quality Assurance Case Manager Ascend BackOffice Solutions LLC - Hollywood, FL

Company: Ascend BackOffice Solutions LLC
Location: Hollywood
Posted on: January 7, 2022

Job Description:

Job Title/Position: Quality Assurance Case Manager

Job Description Summary

The RN Case Manager is a professional registered nurse responsible for supervisory visits of medicare and private duty clients, OASIS, care coordination, and all of the quality activities of the organization. The candidate has accountabilities for the monitoring, implementation, and evaluation of processes and programs to meet regulatory, accreditation, and standards of practice.

Essential Job Functions/Responsibilities

  • Collaborates with nursing caregivers for supervisory visits and provides a process to promote and ensure employee orientation, competency, and in-service education programs.

    • Assists in the identification of skills for annual competence and provides in-service training support.

    • Evaluation, Education, Advocacy, and Caregiver Coaching.

    • Maintains aggregate records of employee orientation and annual competency requirements.

    • Acts as a resource to clinical supervisors regarding standards, policies, regulations and provides in-service training to leadership and personnel as needed in these areas.

    • Intake and Admissions Coordinator

      • Directs all daily patient referral and intake operations including providing direct oversight of the establishment and implementation of intake policies.

      • Establishes and maintains positive working relationships with current and potential referral sources.

      • Ensures seamless transition of patients to home care by providing direct oversight of patient education and preparation for home care, plan of care initiation, and coordination of care with multiple service providers.

      • Assists with patient visits as needed.

      • Assists with on-call evenings and weekends on a rotational basis and clinical calls as needed.

      • As a Case Manager responsible for analyzing, organizing, and prioritizing work accurately while meeting multiple deadlines.

        • Ability to communicate effectively in both oral and written forms.

        • Assist with Assessment on a need basis and Comprehensive Care Planning, facilitation, Care Coordination, and Problem Solving.

        • Care Management Monitoring.

        • Lifestyle, Social and Health Management, Utilization, and Community Resource Coordination.

        • Coordinates and oversees all direct and indirect patient services.

        • Provides guidance and counseling to care teams in continually improving all aspects of client care.

        • Maintains updated nursing knowledge and skills.

        • Assists with patient visits as needed.

        • Responsible for the implementation and monitoring of the organization's quality improvement program as a QA person.

          • Ensures that there are processes in place to monitor and measure all activities related to performance improvement.

          • Provides direction and coordination of quality improvement activities utilizing continuous quality improvement principles and methodologies.

          • Monitor organization clinical compliance with regulatory and accreditation standards as per current knowledge related to Medicare Conditions of Participation (MoP) and the Community Health Accreditation Program (CHAP).

          • Coordinates activities related to clinical record review for data collection.

          • Compiles, trends, and reports quality data in the following areas: patient care, safety, risk management, infection control, outcomes, and customer satisfaction.

          • Works collaboratively with nursing supervisors to assure documentation is complete and consistent with care and reflects legal requirements.

          • As a member of the Patient Grievance Committee collaborates with management personnel in the follow-up of concerns expressed by patients, families, and physicians.

          • Establishes a process model for improvement and provides education and training to organization personnel on the performance improvement plan, as well as team development.

          • Coordinate Monthly and quarterly or as-needed case conferences with all disciplines involved in inpatient care.

          • Responsible for ensuring processes to monitor and evaluate safety, risk management, and infection control programs.

            • Coordinates educate and implement monitoring activities for agency QAPI (Quality Assurance and Performance Improvement program) to include safety, risk management, and infection control.

            • Coordinates mandatory in-service programs on OSHA regulations for safety and infection control.

            • Acts as a resource to personnel in identifying safety and risk management issues for patients and personnel.

            • Reviews all incident reports for completeness, risk, the standard of care determination, and appropriate follow-up.

            • Maintains logs for trending and makes recommendations related to trends identified.

            • Maintains current knowledge related to home care safety and infection control standards.

              The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

              Position Qualifications

              • Registered nurse with current licensure to practice professional nursing in the state.

              • AA or Bachelor's degree in Nursing from an accredited program by the National League for Nursing.

              • Three (3) to five (5) years of clinical nursing experience. (Preferred in care management, Medicare, and private duty clients).

              • Excellent understanding of performance improvement, quality assurance, and utilization management.

              • Is self-directed and able to work with minimal supervision.

              • Has excellent coordination and communication skills.


Keywords: Ascend BackOffice Solutions LLC, Hollywood , RN Quality Assurance Case Manager Ascend BackOffice Solutions LLC - Hollywood, FL, Executive , Hollywood, Florida

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