Claims Quality Auditor jobs in Las Cruces, NM

Job Description

Quality Life Service is a Developmental Disability Waiver Agency who provide services to the DDW community. QLS is seeking out a full time LPN. Duties will include but not limited to identify and supporting our clients with health decisions; support health awareness and self-management of medications and health conditions; provide education to our Direct Support Staff; and share information among the IDT members including DSP in a variety of settings.

Other duties include proactively assisting with chronic and acute health changes and concerns, facilitating access to appropriate healthcare services. This involves communication and coordination both within and beyond the DD Waiver system and typically includes contact and collaboration with the person, guardian, and IDT members, which include: Primary Care Practitioners (physicians, nurse practitioners or physician assistants), specialty practitioners, dentists and the Medicaid Managed Care Organization (MCO) Care Coordinator.

Other Duties include:

• Promotes patient's independence by establishing patient care goals; teaching patient, and Direct Support Staff to understand condition, medications, and self-care skills; answering questions.
• Assures quality of care by adhering to therapeutic standards; measuring health outcomes against patient care goals and standards; making or recommending necessary adjustments; following hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations.
• Protects patients and employees by adhering to infection-control policies and protocols, medication administration and storage procedures, and controlled substance regulations.
• Maintain accurate, detailed reports and records of patient care services by charting in patient portal.
• Maintains continuity among nursing teams by documenting and communicating actions, irregularities, and continuing needs.
• Maintains professional and technical knowledge by attending educational workshops and required Department of Health DDSD trainings.
• Record patients' medical information and vital signs.
• Modify patient treatment plans as indicated by patients' responses and conditions.
• Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans.
• Rotating On-Call Duties.

Job Type: Full-time

Pay: $26.00 - $28.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off

Standard shift:

• Day shift

Supplemental pay types:

• Overtime pay

Supplemental schedule:

• On call

Weekly schedule:

• Monday to Friday

License/Certification:

• BLS Certification (Preferred)
• NM LPN License Certification (Required)

Work Location: In person