Hoag Health System · 5 hours ago
Quality Review Specialist: Home Health
Newport Beach, CA
Full-time
Onsite
Entry Level
1+ years expHoag Health System is a nonprofit regional health care delivery network in Orange County, California. They are seeking a Quality Review Nurse responsible for analyzing OASIS documentation and ensuring compliance with regulations while working with clinical staff.
Hospital & Health Care
Responsibilities
The Quality Review Nurse is a professional, licensed vocational nurse responsible for analyzing data integrity and consistency of OASIS documentation and assessment processes
This position will ensure appropriate ICD-10 coding and sequencing and will work with clinical staff to clarify documentation and data integrity issues
Prospectively reviews all OASIS assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy
Utilizes OASIS variation or alert reports when reviewing OASIS data
Ensures appropriate ICD-10 coding and sequencing as it relates to the patient’s medical condition, including any co-morbidities
Reviews visit utilization for appropriateness of care guidelines and patient condition; reports potential financial losses and/or underutilization to the clinical manager/designee
Notifies organization leadership of problematic trends as a result of OASIS review
Works with managers to address trends that affect the agency’s outcome and process measures noted during OASIS review
Makes OASIS inter-rater reliability visits with clinical staff
Performs other duties as assigned
Qualification
Required
High School diploma or equivalent
One (1) to two (2) years of clinical experience required
Working knowledge of OASIS and ICD-10 coding
Knowledge of federal regulations and state licensure requirements
Current LVN License to practice in the State of California
Current BLS Certification
Preferred
OASIS certification (COS-C) preferred
OASIS Home Health ICD-10 coding certification preferred
Company
Hoag Health System
Hoag is a nonprofit, regional health care delivery system in Orange County, California.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Robert Braithwaite
President and Chief Executive Officer
Eric Cheung
Chief Legal Officer, General Counsel, Senior Vice President
Recent News
PR Newswire
2025-07-14
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