Home Health Utilization Workflow Manager - Weekends Required

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This person is expected to work every Saturday & Sunday. The Weekdays can be flexible.

Graham Healthcare Group is hiring a Home Health Utilization Workflow Manager, RN to join our dynamic team. The Home Health Utilization Workflow Manager, RN will be responsible for analyzing patient data, and the consistency of OASIS documentation, orders, and visit assessments. This position can sit remotely, depending on the candidate’s location.

Home Health Utilization Workflow Manager, RN Job Responsibilities

• 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.

Qualification Requirements:

• 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

About Graham Healthcare Group:

As an innovator in an evolving healthcare world, Graham Healthcare Group has been designing business and technology solutions to drive better care, outcomes, and productivity within its own home health and hospice companies for over 20 years. In the last several years, our solutions have been successfully integrated across the healthcare continuum.

Join the Graham Healthcare Group and enjoy the following benefits:

• Competitive Pay: With opportunity for advancement 
• Health and Welfare Benefits: Various medical, dental, and vision insurance options for you and your family to choose from. 
• Supplemental Benefits: Company paid life insurance and disability benefits.  Also, pre-tax FSA and HSA plans are offered. 
• Generous PTO Packages: 15 days PTO that grows with your tenure, 6 paid holidays, 1 personal day. 
• Retirement: Save for your future with our company offered 401k and Company Contribution Plan.
• Company-Paid Education Programs:  Grow your career by taking advantage of discounts on tuition for selected courses offered by Purdue and Kaplan. 

 Benefits may vary based on your employment status. 

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.

Graham Healthcare Group is an Equal Opportunity Employer