Sep 17, 2020

RN Quality Review Specialist - Home Health

  • Providence Health & Services
  • Torrance, CA, USA

Job Description


Providence is calling a Quality Review Specialist (RN) (Full Time/Day Shift) at our Providence Little Company Of Mary Home Health in Torrance, CA.

This position can be based in Torrance or Burbank, and has the option to work from home. Monday-Friday, no weekends or holidays required.

Please upload a resume reflecting all professional nursing and home health experience.

We are seeking a Quality Review Specialist (RN) who will verify appropriate documentation, compliance, quality of care provided, ensure adherence to the plan of care, and identify document deficiency trends in a proactive approach. The Review Specialist will serve as a role model, consultant, auditor and OASIS expert to staff in the PSCS Home Health Service Line auditing charts for clinical oversight and compliance and adherence to the Medicare guidelines. This position works closely with the Clinical Educator for home health and will be collaborating with clinical leadership to prepare new hires during initial orientation regarding Medicare Conditions of Participation (COP's) and relevant requirements for care and documentation and provide education during the orientation in the timeliness of paperwork and flow of OASIS. The Quality Review Specialist will maintain professional and ethical practice in accordance with Providence core values. S/he is responsible for continuous assessment of agency processes to insure compliance with government regulations/accreditation standards, acts as a resource to the home care clinicians and the leadership team regarding standards, policies, and regulations.

The position reports directly to the Clinical Manager for home health to identify clinical problem areas and ensures document deficiency trends are addressed in a proactive manner. Incumbents will be assigned as needed to perform duties across multiple PSCS Home Health ministries. All OASIS time points will be reviewed at the ministry level prior to locking and submitting data electronically. The Quality Review Specialist will:

  • Explain and mentor clinicians and staff on COP's and on billable skilled visits.
  • Educate and mentor clinicians one on one (in person or over the phone) regarding concerns, questions, accuracy of OASIS data being reviewed.
  • Promote evidence-based practice care and documentation of skilled care.
  • Collaborate with leadership to audit and analyze performance trends in OASIS accuracy.

This position performs all duties in a manner that promotes team concepts and reflects the Providence Health & Services mission, philosophy, and core values of Compassion, Dignity, Justice, Excellence and Integrity. This position will primarily work from home and assignments for reviews will be as needed across all Providence ministries.

In this position you will:

  • OASIS expert to staff in the Home Health Service Line auditing charts for clinical oversight and compliance and adherence to the Medicare guidelines
  • Coordinate orientation program for new staff members
  • Utilize SHP review assessment validation errors/warnings combined with OASIS Answers guidance to coach staff to correct their OASIS using evidence based practice guidelines
  • Work closely with clinical educator to maintain the clinician preceptor program including peer evaluation
  • Assign and delegate preceptor responsibilities
  • Assure new staff are assigned preceptors for orientation
  • Assess effectiveness of preceptors in teaching
  • Determine learning needs of preceptors and provide guidance to preceptors to improve teaching skills
  • Assess orientees’s progress in meeting OASIS goals of orientation and assimilation into ministry
  • Teach/Train OASIS to new hires using Providence CMS-approved template. Assist in development or update of materials for patient/caregiver education related to specific needs
  • Serve as Subject Matter Expert in the area of clinical skills required for Home Health staff
  • Mentor and assists clinical staff with individual learning needs
  • Participate in the Education Committee, and the development and implementation of an annual Education Plan in collaboration with representatives from throughout the Home Health service line
  • Set an example by modeling the Core Values and Behavior Standards and incorporating them into education modules and teachings


Required qualifications for this position include:

  • Associate's Degree in Nursing
  • Current unencumbered California RN license
  • Current California State Driver's license and automobile insurance
  • Current Healthcare Provider CPR certification
  • Current certification in OASIS or as a Home Health and Palliative Care Specialist required (or obtain within 6 months)
  • 3 years recent clinical experience in Home Health/palliative care experience
  • Experience with an Electronic Medical Record (EMR) system
  • Working knowledge of Medicare home health requirements
  • Demonstrated expertise in interdisciplinary Home Health and palliative care for patients of all ages, and in the clinical process (assessment, plan, implementation and evaluation)
  • Demonstrated ability to coach and mentor new staff
  • Familiarity with California State laws, regulations and standards governing Home Health care, including Joint Commission requirements, and with tools for evaluating Home Health care, including Medicare Conditions of Participation
  • Intermediate computer skills including Microsoft Outlook, Excel, Word, PowerPoint. Willingness to learn new information technology

Preferred qualifications for this position include:

  • Bachelor's Degree in Nursing
  • Previous staff leadership/coaching experience

About the location you will serve:

Providence Health & Services Southern California is further developing its physician integration strategy. Historically, the largest asset has been Providence Medical Institute, a medical foundation that provides administrative and other support services to affiliated medical groups. Providence Medical Institute is expected to grow significantly in the next several years, bringing with it facilities, staff and physician growth to support that objective.

We offer a full comprehensive range of benefits - see our website for details

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Quality Nursing

Location: California-Torrance

Other Location(s): California-Burbank

Req ID: 263775