Quality Reviewer
Atlantic Health System
Quality Reviewer
Atlantic Health System
Non-profit healthcare provider with physician network
Quality Reviewer (CRC)
Reports to: Home Care Director
Duties & Responsibilities:
1. Provides timely review of SOC, ROC and Recertification documentation. Utilizes CRC assessment tool to provide clinical feedback related to OASIS accuracy and POC.
2. Accurately codes chart based on primary and secondary reasons for home care through thorough chart review. Reviews and advances 485 in a timely manner.
3. Demonstrates proficient use of home care information system and decision support software.
4. Oversees utilization of resources for Medicare clients by recommending resources to match patient needs.
5.Provides timely feedback and education to clinical staff regarding OASIS and documentation deficits. Timely notification of manager and assistant manager regarding staff non-compliance. Identifies and reports trends which require staff education.
6. Identifies and reports trends which require staff education.
7. Provides education to clinical staff and intake staff:
Develops and implements educational sessions both individually and in team meetings.
8. Participates in agency’s QAPI program:
Participates in performance improvement projects.
9. Assists with growing agency business:
Cross trains to learn new skills
Accepts other assignments to support agency.
10. Attends continuing education to develop proficiency in OASIS review and ICD-10 coding.
Job Qualifications/Experience:
Current NJ RN or PT License
Three Years of Certified Home Care experience
Thorough knowledge of home care regulations and COPs
OASIS and Coding certification desirable
Minimum Salary (Hourly Rate): 50.150000
Maximum Salary (Hourly Rate): 88.280000
Salary Admin Plan: ALH
Non-profit healthcare provider with physician network
Atlantic Health System is a large non-profit healthcare network in New Jersey that runs hospitals, outpatient centers, urgent care clinics, and a physician-led group called Atlantic Medical Group with more than 1,000 doctors across 300 locations. It provides a full range of medical services to communities in New Jersey and New York and lets patients manage care through the MyChart portal, which handles medical records, appointments, and bill payments. Its business model puts earnings back into its healthcare services and facilities, reinvesting to improve care access and community health. The system differentiates itself by being a broad, integrated network of facilities and a large physician group under a nonprofit umbrella, offering coordinated care across many sites. Its goal is to improve community health by delivering comprehensive care and continually expanding access to high-quality medical services.
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