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Level of Care Review Quality Analyst
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Job Description
- Req#: 5096179_w4WcREBqLsDn
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $100,215
- Opportunity for career advancement and growth within the organization
- Remote work with regular travel to designated areas in Virginia
- Engage in meaningful work that improves the health and well-being of Virginians
- Supportive and collaborative work environment
- Opportunity to contribute to quality care initiatives in long-term care facilities
What to Expect (Job Responsibilities):
- Conduct face-to-face assessments for the Level of Care Review (LOCERI) process for Fee-For-Service (FFS) members
- Perform health assessments, data collection, data entry, and maintain communication with healthcare providers
- Complete the LOCERI and ensure entry into the Care Review Management System (CRMS)
- Participate in the Appeals Process, defending assessment-based decisions in the DMAS appeal process
- Collaborate with healthcare providers and state agencies to address policy issues and ensure compliance with regulations
What is Required (Qualifications):
- Must be a licensed LPN or RN in the Commonwealth of Virginia, or possess a bachelor's degree in a Health & Human Services field
- Considerable demonstrated knowledge of Long-Term Services and Supports (LTSS) requirements
- Experience performing health-based assessments and knowledge of the Level of Care Review Instrument (LOCERI)
- Proficiency in Microsoft Office and ability to analyze and apply federal and state laws and regulations
- Experience communicating effectively in writing with internal and external stakeholders
How to Stand Out (Preferred Qualifications):
- Knowledge and experience working with Elderly or Disabled populations of various ages and medical diagnoses
- Familiarity with CCC Plus Waiver and its requirements
#HealthcareServices #QualityCare #RemoteWork #CareerAdvancement #HealthAssessments
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