Practice Advancement Specialist RN in Ventura County, California at Livingston Memorial VNA

Livingston Memorial is looking for a Full Time, 40 hours a week, Practice Advancement Specialist Registered Nurse to join our Quality Team.

Come be a part of a company whose mission for the last 78 years is to deliver the highest quality, compassionate in-home healthcare and support services to Ventura County residents!

Job Summary

The purpose of this position is to assess, monitor and advance clinical practices, particularly in the areas of compliance, documentation, PPS and OASIS case management including utilization review, and critical thinking. This person works collaboratively with the QAPI Manager and the Director of Patient Care Services providing information regarding OASIS competency and care coordination capabilities of the geographic team members.

What You'll Do

• Establish and monitor a team-based Compliance Program, focusing on issues such as fraud detection and prevention, adherence to federal and state regulations, and applicable clinical practice standards, and LMVNA policies and procedures.
• Review OASIS documentation and Plans of Care with the assistance of other QI staff as needed and communicate with individual staff members regarding discrepancies and/or errors and tracks and trends individual staff performance for education and training purposes.
• Work with clinicians and the clinical supervisors to make recommendations for care plan, nursing frequency and duration, and order of other disciplines.
• Review, validate, submit, and track OASIS to CMS, ensuring timely and accurate filings while resolving submission errors and maintaining regulatory compliance.
• Works with Data Analyst to complete Home Health clinical record audits.
• Utilize Careficient and Strategic Healthcare Programs (SHP) analytics and reporting tools to monitor quality outcomes, identify performance trends, and implement strategies to achieve and maintain the organization's Low Utilization payment Adjustment (LUPA) goals.
• Participate in patient case conferences for each team as scheduled.
• Monitor the quality of clinical documentation to implement strategies to improve clinical documentation; monitors medical records for completion time.
• Identifies and monitors indicators of compliance, quality documentation, and clinical outcomes. Responsible for implementing strategies to improve clinical outcomes when indicated.
• Use available data to track utilization and outcome information that is patient and staff specific.
• Provides input and participates in ongoing staff competency and evaluation of performance with the Director of Patient Care Services.
• Communicates findings, issues and problems regarding compliance, documentation and clinical practice to the QI Manager and the Director of Patient Care Services.
• Promotes and facilitates understanding of the fiscal impact of all clinical practices and documentation. Maintains knowledge of third-party reimbursement requirements and regulation.
• Performs other related duties as assigned.

What We're Looking For

• Valid California Registered Nurse License, Physical or Occupational Therapist License
• Valid Basic Life Support Certification
• Valid Driver License and auto insurance
• Minimum 2 years home care experience preferred
• Comprehensive knowledge of Medical Prospective Payment system and fraud issued in home care preferred
• Knowledge of computer, proficient with Microsoft Word and Excel
• Good verbal and written communication skills.
• High level of attention to details.
• Able to work independently, take ownership and responsibility of tasks.
• Strong professional ethics, discretion and judgment.
• Good organizational skills.

What We Offer

• Competitive hourly pay
• Mileage reimbursement
• Paid training and ongoing education
• Bilingual Stipend
• Supportive team environment
• A chance to truly make a difference in the lives of patients and families

Benefits

• Medical, Dental & Vision Insurance
• 403(b) Retirement plan
• Company Paid Life & Disability Insurance
• Flexible Spending Accounts
• Ancillary Insurance (Critical Illness, Accident, Life, Hospital)
• Paid Time Off (PTO)
• Floating Holiday
• Holiday Pay
• Employee Discounts
• Tuition Reimbursement
• Continuing Education opportunities
• Employee Recognition Program

Join a company that is a cornerstone in the community and a leader in healthcare!