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Utilization Review Nurse

Utilization Review Nurse
Erie, PA, United States
Job ID : R0009205
Job ID : R0009205

City: Erie

State: PA

Zip: 16501

Position Overview
The Quality Assurance Nurse is responsible for maintaining client files, preparing for audits and reviewing nursing documentation for appropriateness. The Quality Assurance Nurse reports to the Clinical Director/Nursing Director who oversees all nursing related items in the location.

Essential Job Functions
• Analyze, review and report on charts, charting trends, and quality indicators.
• Updates and coordinates with the supervising nurse and external clinical staff regarding changes in the patients’ treatment plans when necessary.
• Monitor compliance to policies and procedures including but not limited to clinical documentation.
• Resolve charting issues and recommend changes to procedures.
• Update corrections on documentation after retrieval from appointed nurse(s).
• Assist the quality department with surveys and audits as assigned.
• Assist with professional education activities to encourage professional skill proficiency for all agency clients.
• Participate as a consultant in the implementation of chart review tools, standards of care and outcome measures.
• Required to identify clinical problem areas and inform/train staff in the correction of any deficiencies.
• Assist with quality assurance and policy compliance training programs and develop reference materials to resolve inadequacies.
• Develops, implements, and maintains systems to ensure effective and high-quality professional nursing care.
• Maintains confidentiality of all employee/client records and information.
• Acts as a coordinator, facilitator or liaison to committees, teams and outside organizations, as assigned.
• Provides information and education on quality and performance improvement processes to medical supervisory staff.
• Participation in performance improvement projects to increase high quality, cost-effective methods of practice.

Requirements
• Graduate of an accredited Diploma, Associate or Baccalaureate School of Nursing
• Current state licensure as a registered nurse or licensed vocational nurse
• Two years of home healthcare experience (or the equivalent in post-secondary education experience) preferred.
• At least 1 year experience in quality improvement preferred or directly related field
• Advanced knowledge of MS Office Suite applications (including Word, Excel, and Outlook) is required in addition to a thorough knowledge of standard office procedures, human resources practices and file management systems

Preferences
• Two years of directly-related experiences or five years of related experience in a responsible clinical coordinator role is a plus
• Bi-lingual; Spanish speaking preferred

Other Skills/Abilities
• Must be able to adhere to confidentiality standards and professional boundaries at all times
• Quick-thinking and astute decision making skills
• Attention to detail
• Time Management
• Effective problem-solving and conflict resolution
• Excellent organization and communication skills
• Ability to remain calm and professional in stressful situations
• Strong commitment to clinical excellence
• Leadership skills
• Ability to train and supervise staff

Physical Requirements
• Must be able to speak, write, read and understand English
• Occasional lifting, caring, pushing and pulling of up to 25 pounds
• Prolonged walking, standing, bending, kneeling, reaching, twisting
• Must be able to sit and climb stairs
• Must have visual and hearing acuity

Environment
• Performs duties in an office environment during agency operating hours
• Must be able to function in a wide variety of environments which may involve exposure to allergens and other various conditions

Other Duties
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

#Aveanna

Requisition ID: R0009205

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