Chart Reviewer- NY registered RN
The UAS Reviewer, RN will review all clinical documentation submitted by the Assessment Nurses to confirm accuracy and monitor timeliness in accordance with the company policies and State regulatory standards. This will ensure adherence to departmental and regulatory data integrity standards and requirements including contractual obligations with State and Federal agencies such as the New York State Department of Health (NYSDOH) and Center for Medicare & Medicaid Services (CMS).
• The UAS Reviewer, RN is responsible for auditing assessment documents as outlined by MLTC contract standards to ensure a safe service plan for members.
• Review UAS-NY Assessment, tasking tools and documentation to ensure quality and accuracy.
• Compare UAS-NY Assessment, tasking tool and Care plan and/or service plan to ensure correlation.
• Provide Field Assessors with feedback on their documentation as well as guide them towards documentation improvement.
• Maintains updated certification for Uniform Assessment System (UAS) and all updates and new module certification as identified by the Health Commerce System of New York.
• Assist the Clinical Educator, as needed, to determine areas that require immediate remediation.
• NYS RN License and Current Registration.
• Associates degree from an accredited institution. BSN or BS degree preferred. • Experience conducting UAS-NY assessments.
• Proficiency with healthcare terminology such as ICD-10 codes, medical abbreviations, medications.
• Strong interpersonal and organizational skills.
• Excellent written and verbal communication skills.
• Excellent analytical skills, interpretation of data.
• Possess strong critical thinking skills and knowledge of how to work effectively within an interdisciplinary team environment.
• Ability to set priorities and handle multiple assignments.
• Working knowledge of audit techniques and methodologies.