Quality Assurance Nurse

Overview Join our dynamic healthcare team as a Quality Assurance Nurse, where your expertise will drive excellence in patient care and clinical documentation. In this vital role, you will oversee the review and validation of medical records, ensuring compliance with industry standards. Your keen eye for detail and strong understanding of documentation practices, and healthcare workflows will help elevate the quality of care delivered within the facility. This position offers an exciting opportunity to impact patient outcomes positively while working within a collaborative and innovative environment. Responsibilities Conduct comprehensive reviews of medical records to ensure accuracy, completeness, and adherence to clinical documentation standards. Verify proper utilization management by assessing medical necessity, appropriateness of care, and compliance with Medicare, Managed Care, and other payer guidelines. Collaborate with multidisciplinary teams to improve clinical documentation by providing oversight and education to the clinical team. Support utilization review processes by analyzing patient data within EMR (Electronic Medical Record) systems to identify documentation gaps. Ensure all medical records meet regulatory requirements for legal integrity and confidentiality under HIPAA standards. Participate in case management activities including discharge planning, hospice care coordination, and post-acute care documentation review. Maintain detailed logs of audits, reviews, and compliance activities to support continuous quality improvement initiatives. Qualifications Registered Nurse (RN) license with active state licensure. Proven experience in SNF or hospital settings. Strong knowledge of medical terminology and healthcare workflows across inpatient and outpatient settings. Familiarity with EMR/EHR systems such as Point Click Care. Prior SNF background enhances ability to review workflows and documentation accurately. Knowledge of clinical documentation improvement (CDI), MDS (Minimum Data Set), discharge planning, and case management practices preferred. Excellent attention to detail with strong organizational skills; ability to analyze complex clinical data efficiently. Join us to be part of a dedicated team committed to elevating healthcare quality through meticulous review and innovative practices!

Pay:

$32.00 - $49.00 per hour

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Referral program Retirement plan Vision insurance

Work Location:

In person