RN Clinical Manager/QA Reviewer/DON Reliance Home Health Care - 4.0 West Palm Beach, FL Job Details Full-time 7 hours ago Benefits Health insurance 401(k) Paid time off Qualifications HIPAA Electronic health record (EHR) management for billing and coding Attention to detail Task prioritization Health record tracking Medical management Health information management Managing patient records Medical terminology Full Job Description Overview Join our dynamic healthcare team as an RN Clinical Manager/QA Reviewer/DON, where you will play a vital role in ensuring the highest standards of clinical documentation, medical management, and quality assurance. This energetic position offers the opportunity to lead clinical review processes, collaborate with multidisciplinary teams, and uphold compliance with healthcare regulations. Your expertise will directly impact patient care quality and organizational excellence, making a meaningful difference in the lives of patients and providers alike. Responsibilities Oversee clinical documentation review processes, ensuring accuracy and compliance with medical terminology, coding standards (CPT, ICD-9, ICD-10), and regulatory requirements such as CMS and HIPAA. Conduct comprehensive audits of medical records and electronic health records (EHR/EHR systems), ensuring adherence to clinical documentation standards and healthcare policies. Collaborate with case management teams to facilitate appropriate patient care pathways across hospital settings, nursing homes, home care, and outpatient clinics. Review medical coding (DRG, MDS) and ensure proper application for billing accuracy and regulatory compliance. Maintain up-to-date knowledge of health regulation policies including Medicare regulations, long-term care regulations, and CMS guidelines to support continuous quality improvement. Provide mentorship to clinical staff on documentation best practices and support ongoing education related to physiology knowledge, anatomy, medical terminology, and medical records management. Skills Extensive experience with EMR/EHR systems such as Kinnser/Wellsky must be knowledgeable; proficient in electronic health records management. Strong understanding of managed care processes, Medicare regulations, and utilization review protocols. Knowledge of medical coding (CPT, ICD-9/10), DRG assignment, MDS completion, and case management procedures. Familiarity with healthcare compliance standards including HIPAA and state healthcare regulations. Excellent analytical skills for documentation review and medical records auditing; ability to interpret complex clinical data accurately. Effective communication skills for collaborating with multidisciplinary teams Ability to manage multiple priorities efficiently while maintaining attention to detail in a fast-paced environment. This role offers an exciting opportunity to lead quality assurance initiatives that elevate patient care standards while working within a supportive team dedicated to excellence in healthcare delivery. If you are passionate about clinical documentation improvement and possess the skills listed above, we invite you to join us in making a positive impact on healthcare outcomes!

Benefits:

401(k) Health insurance Paid time off

Work Location:

In person