What are the responsibilities and job description for the Quality Review Nurse position at HOPCo?
At HOPCo, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:
- Competitive Health & Welfare Benefits
- Monthly $43 stipend to use toward ancillary benefits
- HSA with qualifying HDHP plans with company match
- 401k plan after 6 months of service with company match (Part-time employees included)
- Employee Assistance Program that is available 24/7 to provide support
- Employee Appreciation Days
- Employee Wellness Events
Qualifications
- Must be a Licensed Registered Nurse (RN).
- Minimum 2 years of experience preferred.
- Knowledge of the health care field and orthopedics.
- Clinical review, utilization review, or quality assurance review experience preferred.
- Knowledge of patient confidentiality, state laws, HIPAA regulations, and medical records procedures.
Essential Functions
- Audit and analyze patient records and data to ensure quality patient care and appropriateness of services or identify opportunities for improvement.
- Investigate questionable claims, analyze investigation findings, and report findings along with recommendations.
- Assist in identifying gaps in quality patient care.
- Monitor the factors that influence quality patient care.
- Review reports of complications and errors to ensure quality patient care and identify gaps
- Assist in enhancing the Excellence Through Evidence program.
- Utilizes extensive knowledge of medical terminology and coding to analyze quality patient care.
- Completes all daily, weekly, monthly, and annual reporting requirements on time with data integrity and in the requested format to ensure appropriate documentation.
- Provides education and coaching for specific population needs as required by the program or department.
The Quality Review Nurse is responsible for promoting quality assurance standards by conducting clinical reviews and chart audits.
Healthcare Outcomes Performance Company team is dedicated to making the lives of others better by practicing exceptional patient care. If you would like to be part of a dedicated, dynamic healthcare team in a challenging, rewarding environment, The CORE Institute is the right place for you to grow your career.
#CORE
Salary : $43
