Registered Nurse Quality Analyst

Job Summary

To enhance quality assurance in skilled nursing facilities, the remote Registered Nurse Quality Analyst will perform quality reviews of SNF/PDPM audits, ensuring compliance with regulatory guidelines while identifying trends and opportunities for process improvement.

Key responsibilities

• Conduct quality reviews of SNF/PDPM audits to validate coding accuracy and compliance with CMS guidelines
• Document findings and provide constructive feedback to auditors, while monitoring for quality trends and process improvements
• Maintain current knowledge of CMS regulations and participate in workflow improvement initiatives

Required qualifications

• Registered Nurse, Licensed Practical Nurse, or Licensed Vocational Nurse license in good standing
• 5+ years of experience in SNF clinical settings, MDS 3.0 completion, and PDPM reimbursement methodology
• Advanced knowledge of MDS 3.0 coding guidelines and skilled nursing facility levels of care
• Experience with Excel, PowerPoint, Outlook, and Word, as well as Encoder tools like 3M
• Familiarity with Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD)