Quality Review (LVN) : Home Health

• The Quality Review Nurse is a professional, licensed vocational nurse responsible for analyzing data integrity and consistency of OASIS documentation and assessment processes.


• This position will ensure appropriate ICD-10 coding and sequencing and will work with clinical staff to clarify documentation and data integrity issues.


• Prospectively reviews all OASIS assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy.


• Utilizes OASIS variation or alert reports when reviewing OASIS data.


• Ensures appropriate ICD-10 coding and sequencing as it relates to the patient’s medical condition, including any co-morbidities.


• Reviews visit utilization for appropriateness of care guidelines and patient condition; reports potential financial losses and/or underutilization to the clinical manager/designee.


• Notifies organization leadership of problematic trends as a result of OASIS review.


• Works with managers to address trends that affect the agency’s outcome and process measures noted during OASIS review.


• Makes OASIS inter-rater reliability visits with clinical staff.


• Performs other duties as assigned.

• High School diploma or equivalent.


• One (1) to two (2) years of clinical experience required.


• Working knowledge of OASIS and ICD-10 coding. OASIS certification (COS-C) preferred; OASIS Home Health ICD-10 coding certification preferred.


• Knowledge of federal regulations and state licensure requirements.

Current LVN License to practice in the State of California

N/A

Current BLS Certification

N/A