Job Description

Quality Utilization Review Nurse - Houston (Remote) Transition Home Healthcare is an elite home health agency serving Houston, TX and surrounding areas since 2010. We are a group of passionate people dedicated to delivering the highest quality services to our patients, families, team members, and the community. Our team is growing and looking for an experienced Quality Utilization Review Nurse (Home Health) (Must be a Registered Nurse in the state of Texas) ***Job is Remote but MUST live in the Houston, TX or surrounding areas. Job Summary: The Quality Utilization Review RN is responsible for ensuring the delivery of high-quality home health services by monitoring, evaluating, and improving care processes. This role involves developing and implementing quality assurance programs, conducting audits, and ensuring compliance with regulatory standards and best practices in home health care. Key Responsibilities: * Quality Monitoring and Improvement:

• Develop, implement, and oversee quality assurance programs and policies.
• Conduct regular audits and reviews of patient care records, documentation, and clinical practices.
• Identify areas for improvement and recommend corrective actions to enhance care quality and patient outcomes.
• Analyze data and trends related to patient care quality and develop strategies to address identified issues.

* Regulatory Compliance:

• Ensure compliance with federal, state, and local regulations, as well as accreditation standards.
• Stay current with changes in regulations and industry standards to ensure the organization’s practices remain compliant.
• Prepare for and participate in regulatory inspections and audits.

* Training and Development:

• Provide training and education to staff on quality assurance protocols, regulatory requirements, and best practices.
• Develop and update training materials related to quality assurance and compliance.

* Patient and Family Interaction:

• Address patient and family concerns related to care quality and resolve issues promptly.
• Review patient satisfaction surveys and feedback to identify areas for improvement.

* Documentation and Reporting:

• Maintain accurate records of quality assurance activities, including audit findings and corrective actions.
• Prepare and present reports on quality assurance performance and outcomes to management.

* Collaboration and Communication:

• Collaborate with clinical staff, management, and other departments to foster a culture of continuous quality improvement.
• Communicate effectively with team members to ensure understanding and adherence to quality standards.

Qualifications:

• Licensure: Valid Registered Nurse (RN) license in Texas.
• Education: Bachelor’s degree in Healthcare Administration, Nursing, or a related field. Certification in quality assurance or a related field is preferred.
• Experience: Minimum of 3 years of experience in a quality assurance role within a healthcare setting, with at least 1 year of experience in home health care.
• Knowledge: Strong understanding of home health care regulations, quality assurance processes, industry best practices, OASIS, Value Based Purchasing & Star Ratings.
• Skills: Excellent analytical skills, attention to detail, and ability to identify and resolve issues. Strong communication and interpersonal skills.
• Certifications: Relevant certifications (e.g., Certified Professional in Healthcare Quality (CPHQ)) are a plus.

Full Time Benefits:

• Competitive Pay
• Generous Paid Time Off (PTO) and Holidays
• Medical
• Dental
• Vision
• Company-paid life insurance & LTD/AD&D insurance
• Short-Term Disability
• Supplemental Insurances (Hospital Indemnity, Cancer Policies, Legal Plans, & More!)
• 401(k) company match

We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Job Tags

Holiday work, Full time, Temporary work, Local area,

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