What are the responsibilities and job description for the quality assurance nurse for hospice position at Aura one hospice?
Overview
Join our dedicated healthcare team as a Quality Assurance Nurse for Hospice, where your expertise will ensure the highest standards of patient care and compliance. In this vital role, you will oversee clinical documentation review, quality improvement initiatives, and regulatory adherence, all while supporting compassionate hospice services. Your critical thinking and attention to detail will help uphold our commitment to delivering exceptional end-of-life care with dignity and respect.
Duties
- Conduct comprehensive reviews of medical records, clinical documentation, and coding accuracy to ensure compliance with Medicare, NCQA standards, and other regulatory requirements.
- Collaborate with interdisciplinary teams to improve documentation practices, supporting clinical documentation improvement (CDI) initiatives.
- Perform utilization review and management to optimize patient care plans while adhering to hospice guidelines and policies.
- Monitor adherence to HIPAA regulations and ensure confidentiality of patient medical records across EMR systems such as Cerner, Athenahealth, and eClinicalWorks.
- Assist in discharge planning by reviewing case management processes, ensuring proper documentation for hospice eligibility and services.
- Support coding accuracy by applying ICD-10/ICD-9/ICD coding, CPT coding, DRG assignment, and ensuring precise medical terminology usage in documentation.
- Participate in audits and quality improvement projects related to inpatient, outpatient, home care, and hospice services to promote continuous enhancement of care quality.
Requirements
- Registered Nurse (RN) license with current state licensure.
- Proven experience in hospice or palliative care settings with a strong understanding of hospice regulations and standards.
- Critical care experience such as ICU or Level I/II trauma center background highly preferred.
- Familiarity with EMR/EHR systems including Cerner, Athenahealth, or eClinicalWorks; experience with Epic is a plus.
- Knowledge of medical coding (ICD-10/ICD-9), CPT coding, DRG assignment, and utilization review processes.
- Strong understanding of physiology, anatomy, medical terminology, and healthcare documentation best practices.
- Experience with managed care programs like Medicare and Medicaid; familiarity with discharge planning and case management processes.
- Excellent attention to detail in medical records review and documentation accuracy; ability to interpret complex clinical data effectively.
- Knowledge of HIPAA regulations and health information management standards to ensure patient privacy and data security. Join us in making a meaningful difference by ensuring the highest quality standards in hospice care delivery!
Pay: $40.48 - $48.75 per hour
Benefits:
- 401(k)
- Health insurance
Work Location: In person
Salary : $40 - $49