Medical Quality Assurance Nurse l WFH l Night shift

Position: Medical Quality Assurance Specialist

Location: Global One Eastwood Quezon City

Work setup & shift: WORK FROM HOME l Nightshift

Why join us?

You'll have:

Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses

A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.

Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.

Career Growth: Take advantage of opportunities for continuous learning and career advancement.

Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Your Role:

As a Medical Quality Assurance Specialist, you will:

Audits daily notes for proper documentation and ensures chart reviews are timely, accurate, and meet all data requirements under CMS guideline
Collaborates with field clinicians who are taking care of patients in their homes
Reviews charts for quality of care rendered, i.e., orders followed, appropriate contacts with physicians and other disciplines.
Monitors compliance with both internal standards and regulatory requirements and makes recommendations for the adjustment of company programs accordingly. Develops and implements appropriate plans of action to correct identified deficiencies as needed.
Stays up-to-date on clinical programs, processes, and changes
Works directly with the DON in coordinating quality improvement activities, including tasks related to analyzing, reviewing and reporting on notes, charts, charting trends, and quality assurance indicators. Kinnser/Wellsky is our main online patient data management application.
Identifies peer review cases through internal and external sources as appropriate. Collaborates in planning, implementing, and evaluating department activities. Assist DON and staff in the evaluation of programs and effect changes as necessary to improve programs and assure compliance with regulatory requirements.
Updates and works interactively with the supervising nurse and external clinical staff regarding changes in the patients’ treatment plans when necessary.
Monitors compliance to policies and procedures including but not limited to clinical documentation.
Resolve charting issues and recommend changes to procedures.
Participate as a consultant in the implementation of chart review tools, standards of care, and outcome measures.
Attends case conferences and reports audit findings with staff.
Performs other assignments as requested and assigned.

What You Need:

Non-negotiables:

Minimum of 1 year experience in a healthcare setting.
Nursing Graduate
Prior audit experience of medical chart and medical coding experience.
Licensed Practical Nurse