Quality Reviewer

Visiting Nurse Association of the Treasure Coast; Vero Beach (FL); On-site; USD 60,000 - 80,000; Full time

Job summary

Visiting Nurse Association of the Treasure Coast is seeking a Quality Reviewer to support home health quality of care, data accuracy, and documentation reviews. You will review OASIS timepoints, verify coding, and ensure plan of care aligns with agency and payor requirements.

You will collaborate with clinicians, managers, and the QAPI team to identify training needs and improve outcomes. The role emphasizes regulatory compliance and ongoing record accuracy.

Qualifications

• OASIS coding and review experience is required.
• Knowledge of CMS Home Health regulations including COPs.
• Experience with ICD-10 coding is a plus.
• Active RN or PT license in Florida.
• Current Basic Life Support for Health Care Provider Certification/CPR.

Responsibilities

• Review and approve all patient information and clinician documentation at OASIS timepoints (SOC, ROC, Recertification, Evaluation visit or Discharge).
• Analyze OASIS data to ensure accuracy.
• Review diagnosis coding and plan of care (POC/485) for accuracy and completeness.
• Assure appropriateness of patients to home care requirements and adherence to payor rules and regulations.
• Communicate with assessing clinicians and clinical managers to facilitate care planning during admission.
• Identify high risk cases needing interdisciplinary case conferencing.
• Review clinical records for accuracy and completeness on an ongoing basis.
• Collaborate with QAPI nurse and home health educator regarding review findings and training needs.
• Participate in QAPI Committee.
• Other duties as assigned.

Skills

OASIS coding & review

CMS Home Health regulations

ICD-10 coding knowledge

Homecare Homebase EMR

RN or PT license in Florida

BLS/CPR certification

Education

Licensed RN or PT in Florida

Tools

Homecare Homebase EMR

Job description

The Quality Reviewer position support efforts of VNATC Home Health in managing quality of care, utilization, documentation and outcome and process management through associate interaction, education and timely review of electronic patient records. Integrate and demonstrate the core values of the VNA in all aspects of work responsibilities.

Responsibilities:

1. Review and approve all patient information and clinician documentation that is provided by the assessing clinician during OASIS timepoints (SOC, ROC, Recertification, Evaluation visit or Discharge)
2. Analyze OASIS data to ensure accuracy of data.
3. Review diagnosis coding and plan of care (POC/485) for accuracy and completeness
4. Assure appropriateness of patients to home care requirements and adherence to all payor rules and regulations
5. Communicate regularly and effectively with assessing clinicians and clinical managers to facilitate care planning at all points within the client’s admission
6. Identify high risk cases that require interdisciplinary case conferencing
7. Review clinical records for accuracy and completeness on an ongoing basis
8. Collaborate with QAPI nurse and home health educator regarding review findings and training needs
9. Participate in QAPI Committee
10. Other duties as assigned

Qualifications:

• At least one year recent Home Health experience related to OASIS coding and review
• Knowledge of CMS Home Health regulations including current COPs
• Knowledge of (or experience with) ICD-10 coding is a plus
• Experience with Homecare Homebase EMR preferred
• Active RN or PT license in the State of Florida
• Current Basic Life Support for Health Care Provider Certification/CPR