OASIS Review RN - Hospice

Spartanburg Regional Healthcare System•Spartanburg, SC

About The Position

We are hiring an OASIS Review RN to join our Hospice team! This is a Full-Time position with working hours from 8:30 am to 5:00 pm. The Clinical Review RN is responsible for reviewing admission and discharge data to ensure it is appropriate, complete, and compliant with state and federal regulations. This role ensures appropriate coding and sequencing related to the patient's medical condition, including co-morbidities and current guidelines. The RN will consult with clinicians to clarify data integrity and documentation, and evaluate the accuracy of admission and discharge data at each time point. They will provide ongoing Quality Reporting Program (QRP) and documentation education to clinicians, and follow up to ensure timely corrections. The position involves reviewing admission, discharge, and Plan of Care data for accuracy, appropriateness, and congruency, and ensuring all necessary documentation is completed by all disciplines for transmission. The RN will notify management of trends noted in QRP documentation and assist with billing audits and issues as needed. Participation in the quality assessment performance improvement process is also expected. Other duties may be assigned.

Requirements

Graduate of an approved nursing program
One (1) year Home Health/Hospice experience or Quality experience
Current license to practice as a Registered Nurse in South Carolina

Responsibilities

Review admission and discharge data to ensure appropriateness, completeness, and compliance with state and federal regulations.
Ensure appropriate Coding and sequencing as it relates to the patient's medical condition, including any co-morbidities and current guidelines.
Consult with the appropriate clinician to clarify data integrity and documentation.
Evaluate the accuracy of admission and discharge data at each time point to ensure the data is collected, encoded, and reflects the patient's status at the time of the assessment, based on the clinician's documentation.
Provide ongoing Quality Reporting Program (QRP) and documentation education to clinicians as needed.
Follow up with clinicians to ensure timeliness of admission and discharge data corrections.
Review admission and discharge and Plan of Care data for accuracy, appropriateness, and congruency.
Ensure the completion of all necessary documentation by all disciplines for the completion and transmission process based on state and federal regulation.
Notify management of trends noted in QRP documentation as a result of data review.
Assist with billing audits and issues as needed.
Participate in quality assessment performance improvement process.
Perform other duties as assigned.
Submit Quality Reporting Data assessments based on federal and state regulation.
Works with Clinical Leadership to address trends that affect the agency's outcome and process measure noted during clinical review.
Train and function as a field RN clinician, as needed.