For over 40 years Pathways has been a Bay Area pioneer, leader and innovator in Hospice, Home Health, Palliative Care, Private Duty, and Care Management services. We provide care at home or in settings such as assisted living, a nursing home, or the hospital. We have offices in Sunnyvale, South San Francisco, and Oakland. Patients and their families know us for our personalized, high quality care, delivered with empathy, kindness, and respect.
AREAS OF RESPONSIBILITY:
The Quality Reviewer in Home Health supports the organization’s mission to maintain compliance with all mandatory regulations and continuously improve the quality and service of care. The ideal candidate will conduct reviews of home health clinical records for accuracy of OASIS, compliance with The Joint Commission and Medicare Conditions of Participation rulings, and compliance with evidenced based standards of care; makes corrections in charts as needed. He or she will communicate the need for change to the clinicians, and reports problem areas to the Education Program Manager in Home Health; assists the Education Program Manager in educating staff on improvement activities when needed. The individual will assist in Performance Improvement studies and other Quality Management activities as needed to support the organization’s improvement.This individual also performs other duties as assigned consistent with skills and training for this position in alignment with the goals and mission of Pathways Home Health & Hospice.
• Licensed by the California Board of Nursing as a RN or LVN required
• OASIS Certification required within six months of hire
• Prior experience with home health chart review and/or utilization review required
• Experience using the medical records documentation system EPIC desired
• Proficient in computer applications; Excel, Outlook, Microsoft Word
• Knowledgeable of regulations covering Home Health