Home Health Clinical Quality LVN

UnitedHealth Group • San Antonio, TX

2d • $20 - $36

About The Position

Explore opportunities with WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for helping people achieve improved health outcomes. Explore rewarding opportunities for physicians, clinical staff and non-patient-facing roles. Join us and discover the meaning behind Caring. Connecting. Growing together.
The Home Health Quality Assurance LPN/LVN, under the supervision of QA RN, audits clinical records for compliance to all applicable laws, federal and state rules and regulations and Agency’s policies and monitors factors which directly and indirectly influence the care rendered to the patients.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Requirements

• Graduate of an accredited LVN/LPN program
• Current licensure as a Licensed Vocational Nurse in good standing with the Board of Nurse Examiners for the state of Texas
• 2+ years of experience as an LPN/LVN in a home health care environment
• Ability to define problem, collect data, establish facts, interpret an extensive variety of technical, medical, regulatory instruction and deal with numerous issues to draw a valid conclusion

Nice To Haves

• 2+ years of Home Health QA experience
• Proficient computer skills, including Microsoft Word, Excel and Outlook
• Excellent verbal and written communication skills
• Ability to interact productively with individuals and with multidisciplinary teams
• Excellent organizational and prioritization skills

Responsibilities

• Performs audits of 100%25 of all OASIS and PT/OT/ST evaluations for the assigned Branch and clinician alpha under the supervision of a Registered Nurse, to make sure the clinician/therapist followed relevant regulatory guidelines, policies and procedures
• Performs 75%25 to 100%25 audits of all daily skill visits notes performed by the RN’s, LVN or therapist, depending on the clinician’s return for review records in the previous 90 day period. Duty performed under the supervision of a Registered Nurse
• Evaluates the documentation of medical care to make sure the clinician/therapist followed relevant CMS regulatory guidelines and the Agency’s policies and procedures
• Checks to make sure that all physician orders are followed and that there is an order in the EMR system for the skill visit performed by the clinician
• Verifies that all necessary documentation is included in the EMR
• Returns OASIS/evaluation/skill visit note to the clinician if additional documentation is needed, for correction or if additional information is necessary to be in compliance
• Based on review of clinical documentation, identify potential quality of care issues and potential fraud/waste/abuse
• Monitors and reports market and clinician specific trends identified to manager for further review, action or additional clinician education
• Assists in developing processes to improve quality of notes
• Educates clinician on proper documentation needs for regulatory compliance
• Establishes a trusting relationship with clinicians and co-workers
• Exhibits professionalism and is courteous with all clinicians and co-workers
• Demonstrates knowledge and observance of Patient’s Bill of Rights and Notice of Privacy Practices
• Participates in educational programs and all required in-service programs to maintain comprehensive QA knowledge base, as assigned by supervisor
• Complies with all Homecare Dimensions, Inc. Agency’s policies and procedures. Promotes and maintains an agency environment that is in compliance with federal, state, and local regulatory agencies. Participates in the agency’s endeavors for accreditation, licensing and professional recognition according to state, federal and/or CHAP’s requirements
• Demonstrates personal responsibility with regard to attendance and punctuality
• Maintains privacy and confidentiality with regard to all patient, staff and agency information
• Expresses verbal and written communication in a clear, positive and cooperative manner
• Demonstrates flexibility, enthusiasm and willingness to cooperate while working with others or in place of others, as necessary
• Promotes the agency image by adhering to the Dress Code
• Performs all other QA related duties as assigned
• Maintains LPN/LVN licensure current, at all times, and in good standing with the Board of Nurse Examiners for the state of employment

Benefits

• In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
• No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees