Plan of Care Review (PHRN and USRN)

•    Conduct thorough review of patient’s Plan of Care for completeness, accuracy, and alignment with clinical protocols and patient-specific needs.
•    Identify and address required corrections within the required timeframes to avoid delays in patient care delivery.
•    Facilitate corrected Plan of Care routing for physician approval within required timeframes.
•    Maintain accurate and timely records of all Plan of Care reviews, including notes on identified issues, communication with clinicians, and status of physician approvals.
Serve as a clinical liaison between nurses, clinicians, case managers, and physicians to verify alignment on the patient’s care goals and treatment plan
•    Escalate unresolved issues or repeated documentation concerns to the appropriate leadership or quality assurance team.
•    Promote patient safety and continuity of care by actively participating in process improvements and audits related to Plan of Care quality and turnaround time.
•    Adhere to applicable regulations (e.g., CMS guidelines), internal policies, and quality standards related to home health documentation and care coordination.

Others 
•    Reports suspected compliance issues (e.g., data disclosures, etc.) on the day of discovery to a Team Lead, Manager, and/or the Compliance Department. 
•    Support compliance by knowing, understanding, correctly interpreting, and accurately applying regulatory requirements and statutes. 

Performance Management 
•    Maintains active USRN and/or PHRN Licensure. 
•    Responsible for notifying Team Lead, Manager, and/or Compliance Department immediately of any expiration or change in status of active USRN and/or PHRN licensure. Does not perform clinical duties unless active licensure is documented and on file within the PMO department. 
Adheres to production and quality metrics.

Security Compliance 
•    Employees are required to maintain compliance with company safety, security and privacy programs (secrecy of all information and project-related information that may be acquired about the business, its affiliates and partners). They are responsible for being active participants of programs that protect the company’s business operations, facilities, and physical and intellectual property and ensure a safe and secure working environment for all employees. 
•    Employees must adhere to policies relating to the confidentiality of Protected Health Information (PHI) including, without limitation, clinical information or data obtained by them (oral, written, or electronic) only for the purposes necessary for conducting business of the organization, including evaluation activities.
 

Skills and Qualifications:

• Bachelor of Science Nursing (BSN) degree or General Nursing & Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing Diploma. 
•  Holds current and unrestricted PH Registered Nurse license. 
•    Three (3) months prior clinical experience, this is equivalent to 480 hours of working experience as a Registered Nurse
• Excellent written and verbal communication skills in English. 
• Proficiency in basic computer knowledge with the ability to learn additional computer programs.

#LI-PH

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