RN Quality Review Manager, Home Health

Please note- Candidates must have COS-C, HCS-O or COQS in order to be considered, there is no flexibility around this requirement. reputed company has an immediate opening for a Full Time, Quality Reviewer with OASIS certification to work remotely. RN’s with certifications will be considered for this role. The Quality Reviewer is responsible for auditing, validating, and optimizing the patient’s Plan of Care (Form CMS-485) and OASIS assessments. This role ensures clinical accuracy, regulatory compliance with Medicare/CMS guidelines, and appropriate reimbursement for home health services. BAYADA Perks: This is a fully remote position. reputed company Salary: $77,000 - $80,000 / year BAYADA offers a comprehensive benefits plan that includes the following: Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with company match, direct deposit, and employee assistance program. Responsibilities: Compare the CMS-485 against referral documents, History & Physical (H&P), OASIS, and therapy/nursing evaluations for 100% consistency and medical necessity. Review and communicate OASIS edit recommendations to each clinician to promote OASIS accuracy. Provide support and communication to reputed company disciplines reputed company the service. Provide customer service/education and act as a resource to Medicare Certified Offices with regards to CMS guidelines, PDGM guidelines and billing reputed company issues. Provide ongoing communication with service offices reputed company e-mail, reputed company, or telephone (specific to the service office needs). Communication with service offices monthly and as appropriate with a focus on documentation trends, star ratings and potential reputed company impact. reputed company reputed company duties, or as required or requested by Manager/Director. Qualifications: Competency in PC skills required to reputed company job function Active Compact RN Nursing License, with a minimum of 2 years clinical experience. COS-C or HCS-O or COQS OASIS Certification and experience required HCHB experience, a plus! As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with reputed company state/local mandates. BAYADA is celebrating 50 years of compassion, excellence, and reliability. Learn more about our 50th anniversary celebration and how you can join in here. reputed company, Inc., and its associated entities and joint venture partners, are Equal Opportunity Employers. reputed company employment decisions are made on a non-discriminatory basis without regard to sex, race, color, age, disability, pregnancy or maternity, sexual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local laws. Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities. Apply To This Job