Quality Review & Staff Education Specialist
- Healthcare
- UAS-NY assessment
- quality assurance
- staff education
The Quality Review & Staff Education Specialist ensures the accuracy and integrity of UAS-NY assessment data by conducting audits and identifying trends for retraining. This role involves training and educating Assessment Nurses, developing educational modules, and collaborating with clinical management to implement corrective actions. The specialist also participates in interdisciplinary meetings, performs enrollment follow-ups, and travels to deliver staff orientation and training.
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Assessment Quality Review Specialist and Staff Educator is responsible for quality assurance, accuracy and overall integrity of the UAS-NY assessment data and visit documentation completed by core team nurses as well as, business partners’ nurses. This responsibility is fulfilled by performing assessment audits, identifying trends that require staff retraining, and implementing corrective action plans in collaboration with Clinical management staff. The position is also responsible for ongoing orientation, training and education of Assessment Nurses conducting UAS-NY assessments. He/She will participate in establishing educational modules for staff orientation and re-training. Position requires to travel as part of ongoing orientation, training and education, as well as to perform UAS-NY assessments on an as needed basis.Conduct Enrollment Visits follow up for HF nurses and business partners, including NTUC note completion, Visit Outcome Follow Up. Assist with completion of Deferral Calls, and Transfer Calls and notify appropriate parties of outcome. Maintain accurate productivity log of Enrollment processes follow-up. Prepare for RFS (Request for Service) and IDT (Interdisciplinary Team) meetings by conducting UAS-NY assessment review and relevant documentation conducted by core field staff and business partners to ensure correlation within the assessment and validation of Tasking Tool completion. Participate in RFS and IDT meetings, follow-ups with Assessment Nurses if documentations’ amendments are required. Identifies inconsistencies trends and provides suggestions for corrective action plan for identified assessment deficiencies to Field Assessment management.
• Baccalaureate degree in nursing required
• Master's degree in nursing, education or related field preferred
• Minimum of two (2) years clinical experience required
• Managed Care experience preferred
• UAS-NY experience required
• Requires a NYS Registered Nurse license and registration
• Excellent analytical skills, interpretation of data
• Strong critical thinking skills
• Knowledge of Medicare and Medicaid regulations
• Ability to set priorities and to handle multiple assignments
• Working knowledge of audit techniques and methodologies
• Working knowledge of State and Federal regulations
• Travels to perform business partners training and clearance visits
About MJHS Health SystemOne hundred and ten years ago, four courageous women in Brooklyn saw people in desperate need of care and loving kindness. Determined to do something, they made it their mission to change what they saw. Based on the core values of compassion, dignity and respect, and with the help of charitable support, these determined women provided poor, elderly members of the community with quality health care and a safe place to live. Although MJHS Health System has grown from caring for dozens of patients to thousands, the mission to provide the best care and comfort possible has never wavered. Since 1907, the organization has expanded from one small building among the tenements to one of the largest not-for-profit health systems in the region that provides home care, hospice and palliative care for adults and children, a center for rehabilitation and nursing care and the research-based MJHS Institute for Innovation in Palliative Care. It also includes Elderplan, which offers health plans for Medicare and Dual Eligible beneficiaries and its managed long- term care plan, HomeFirst, one of the original MLTC plans in New York. Many MJHS Health System programs and services are aided by grants from MJHS Foundation, which is supported by private and corporate donations. For more information, please visit www.mjhs.org, facebook.com/MJHS01, twitter.com/MJHS01, youtube.com/MJHS01 or call 1-855-692-5058. Interested in working at MJHS? Visit www.mjhs.jobs

