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Utilization Quality Audit Reviewer

Department:  SNH CLINICAL SERVICES

Job Details

Req Id    59521 
Department    SNH CLINICAL SERVICES 
Shift   Days
Shift Hours Worked    7.50 
FTE    
Work Schedule    SALARY GENERAL 
Employee Status    A1 - Full-Time 
Union  Non-Union

Job Summary

The Quality Improvement Reviewer/Educator is responsible for developing, implementing, and evaluating Home Care Services quality improvement /staff education practices to ensure that quality patient centered home care services are provided. This includes the maintenance of, and adherence to each agency(s) policies and procedures governing Home Care Service agencies to ensure compliance with State & Federal Regulations.

Core Job Responsibilities

  • In collaboration with the Director of Quality Improvement, maintains records and reports to support and document Utilization Review/Quality Improvement activities.
  • In collaboration with the Director of Quality Improvement, responsible for completing record audits for home care/member services per state and federal regulations.
  • In collaboration with the Director of Quality Improvement, responsible for compiling and maintaining audit record statistics and utilizes outcome reports to educate front line staff to improve patient/member outcomes.
  • In collaboration with the staff education supervisor, serves as educational resource to home care services clinical staff.
  • Participates in regular team meetings and activities.
  • Participates in departmental and organizational committees and meetings as applicable.    
  • Performs other related duties as requested by the Executive Director or Director of Patient Services.                                                              

Education/Experience Requirements

Required: An associate’s degree in applied science with a current NYS registered nursing license with 1 years of home care experience; Physical exam signed by a physician showing you are in good health and have the immunizations required by the New York State Department of Health.

Preferred: Computer literacy, including but not limited to data entry, retrieval, and report generation; Ability to work with patients/families of all ages and in a variety of settings, including inpatient facility and patients’ homes presenting diverse physical conditions and social/cultural environments; Ability to drive to and from a variety of settings in varying weather conditions; Ability to perform physical tasks which include sitting, standing, walking, pushing, pulling, climbing stairs, bending, and may include lifting a minimum of 40 pounds.

Licensure/Certification Requirements

Required: An associate’s degree in applied science with a current NYS registered nursing license with 1 years of home care experience; Valid New York State driver’s license.
Preferred: 

EOE AA M/F/Vet/Disability

Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.

Successful candidates might be required to undergo a background verification with an external vendor.


Nearest Major Market: Utica