Home Health Utilization Workflow Manager

Job Title

Home Health Utilization Workflow Manager

Location

Glen Carbon, IL, USA

Additional Location(s)

Employee Type

Employee

Working Hours Per Week

40

Job Description

At Residential Home Health and Hospice ('Residential'), we're looking to add to our extraordinary care team. Grounded by our belief that outstanding care is best delivered in a team-based environment, our Home Health Utilization Workflow Manager will partner with our field staff and leaders to provide the best support to the patients that we serve. This position will be responsible for analyzing patient data, and consistency of OASIS documentation, orders, and visit assessments.

With our 20-year track record, Residential is a strong leader in the industry. We are consistently named a Top Workplace by our employees and genuinely care where you are in your career path.

Our high value rewards package:

• Up to 22 paid holiday and personal days off in year one

• DailyPay: Access your money when you want it!

• Industry-leading 360 You benefits program

• Company paid emotional health and wellness support for you and your family

• Adoption assistance

• Access to Ramsey SmartDollar

Certain benefits may vary based on your employment status.

What you'll do in this role:

• Assures compliance with timeliness, accuracy, and content of clinical documentation in accordance with applicable regulations and industry standards.

• Reviews clinician OASIS documentation and plan of care review for the assigned team(s).

• Approves plan of care to send to signing provider after verifying complete and relevant content, accuracy, orders, treatments, and discipline-specific goals and visit frequency that aligns with the referring provider documentation and in-home visit note.

• Provides recommendations related to the plan of care and/or OASIS inconsistencies, omissions, and/or discrepancies with the available documentation in the chart, approved by the clinicians who completed the in-home visits.

• Evaluates and verifies appropriate visit frequency meets the needs of the patient and ordering provider and is supported by the plan of care in collaboration with the assessing clinician.

• Recommends appropriate service utilization by discipline using HCHB tools and reports.

• Runs SHP analyzer tools and addresses alerts for clinical documentation improvements.

• Notifies the clinician about plan of care set up when the chart results in a LUPA (low utilization payment adjustment) which may put the patient at risk for hospitalization.

• Participates in case conferences to support a team-centered approach for service utilization and outcomes.

• Collaborates with coding partners to complete timely OASIS workflow.

• Obtains additional provider or facility patient records that may contribute to the accuracy of the plan of care or OASIS question.

• Minimum of two years' experience in home health with experience in quality, supervisor, or staff development roles.

• Licensed RN in good standing from an accredited program required

• HCHB experience preferred

• ICD Coding/OASIS certification preferred

• Able to work in a fast paced environment

NOTICE:

• Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana.

• By supplying your phone number, you agree to receive communication via phone or text.

• By submitting your application, you are confirming that you are legally authorized to work in the United States.

Residential Home Health and Residential Hospice is an Equal Opportunity Employer