QI Nurse
- Maintains current knowledge of condition of participation, Medicare and Medicaid.
- Maintains current knowledge of OASIS including process measures and outcomes.
- Timely review of Medicare final claims.
- Completes all Medicare RAPS prior to month’s billing close date.
- Reviews SOC, recerts and discharge documentation for appropriate ICD-9 coding, HHRG’s and outcomes.
- Weekly meeting with assigned Team Manager to discuss outstanding documentation issues and problematic clinicians.
- Attends weekly care co-ordination meeting and facilitates meeting in Manager’s absence.
- Performs monthly OASIS audit visits.
- Acts as a resource for clinical staff.
- Notifies QI Director of problematic/risk areas along with a solution to prevent reoccurrence.
- Completes incident reports for non-compliance of Agency policies and procedures.
- Administers Manitou’s
- On-call responsibilities to meet the agency’s need.
- All other tasks as assigned by Supervisor.
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