Quality Review (LVN) : Home Health at Hoag

Newport Beach, California, United States -

Full Time

Start Date

Immediate

Expiry Date

15 Oct, 26

Salary

52.67

Posted On

17 Jul, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

OASIS Documentation, ICD-10 Coding, Data Integrity Analysis, Clinical Review, Regulatory Compliance, Patient Assessment, Inter-rater Reliability, Visit Utilization Review

Industry

Hospitals and Health Care

Description

Primary Duties and Responsibilities * The Quality Review Nurse is a professional, licensed vocational nurse responsible for analyzing data integrity and consistency of OASIS documentation and assessment processes. * This position will ensure appropriate ICD-10 coding and sequencing and will work with clinical staff to clarify documentation and data integrity issues. * Prospectively reviews all OASIS assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy. * Utilizes OASIS variation or alert reports when reviewing OASIS data. * Ensures appropriate ICD-10 coding and sequencing as it relates to the patient’s medical condition, including any co-morbidities. * Reviews visit utilization for appropriateness of care guidelines and patient condition; reports potential financial losses and/or underutilization to the clinical manager/designee. * Notifies organization leadership of problematic trends as a result of OASIS review. * Works with managers to address trends that affect the agency’s outcome and process measures noted during OASIS review. * Makes OASIS inter-rater reliability visits with clinical staff. * Performs other duties as assigned. Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year. For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy. Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes. Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California. To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/ [https://www.hoag.org/about-hoag/awards-accreditations/]. Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.

Responsibilities

The Quality Review Nurse analyzes OASIS documentation and ICD-10 coding to ensure data integrity and compliance with federal and state regulations. They collaborate with clinical staff to address documentation trends and perform inter-rater reliability visits.