Quality Analyst - Skilled Nursing Facility (SNF) / Patient-Driven Payment Model (PDPM)

Responsibilities: Conduct quality reviews of completed audits to ensure compliance with CMS regulations, internal policies, and client requirements. Evaluate the accuracy and consistency of audit determinations while identifying trends for process improvement.

Requirements: Requires a valid RN, LPN, or LVN license and over 5 years of experience in SNF clinical, MDS 3.0, and PDPM reimbursement. Candidates must be proficient in Encoder tools like 3M and have expertise in Medicare LCD and NCD guidelines.

Key skills: SNF Clinical, MDS 3.0 Completion, PDPM Reimbursement, Quality Assurance, Auditing, HIPPS Codes, Excel, PowerPoint, Outlook, Word, 3M Encoder, LCD, NCD, Verbal Communication, Written Communication, Detail Oriented

Keywords: SNF, PDPM, MDS 3.0, CMS Regulations, HIPPS Codes, 3M Encoder, Medicare Local Coverage Determinations, National Coverage Determinations, Quality Analyst, Healthcare Auditing, Clinical Review, Data Analytics, Compliance Monitoring