QI Nurse

The Registered Nurse (RN), preferably certified in OASIS coding, is responsible for clinical chart reviews, quality and performance improvement activities, and assisting with the education and ongoing development of clinical staff. The RN must be licensed in the state of Massachusetts. This position follows a hybrid work schedule consisting of three remote days and two in-office days per week, with additional in-office presence as required by management.

• 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.

Experience, Education, and Licensure

Graduate of an NLN accredited school of nursing, preferable a B.S.N. or B.S. program. Knowledge of rules and regulations of participation in a Medicare certified home health agency is preferred. Possesses a sound clinical knowledge and practice and has the ability to problem solve. Current Registered Nursing Licensure in state where client services are being rendered. Must be familiar with MS Word, Outlook and Excel.

Language Skills

Ability to read, analyzes and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

Since 1911, All Care has been expanding programs and services to meet the changing needs of the patients we serve. All Care’s dedicated health care professionals and caring staff provide the highest quality, compassionate services to patients and families throughout the North Shore, Eastern MA, Greater Boston & Merrimack Valley communities. All Care specializes in providing a full continuum of in-home services. From nursing and rehabilitation therapy to palliative and hospice care to private pay services and adult foster care, we offer solutions, resources, and assistance to each patient and family ensuring quality of life at every phase of need. All Care is Medicare certified and licensed by the Commonwealth of Massachusetts.