Utilization Workflow Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluate patient data as well as the consistency of OASIS documentation, orders, and visit assessments.

• Review coding, the accuracy of OASIS, completion, compliance, accreditation, and adherence to utilization standards.

• Assess clinician OASIS documentation and care plans.

• Approve care plans for provider signatures after confirming content, accuracy, orders, treatments, goals, and visit frequency.

• Suggest corrections for inconsistencies, omissions, and discrepancies in plans of care and OASIS documentation.

• Oversee OASIS locking for each event and ensure workflows are completed within the required timeframe.

• Collaborate with assessing clinicians to evaluate visit frequency and service utilization.

• Utilize HCHB tools and reports to recommend appropriate discipline-specific utilization.

• Employ SHP and other company-provided analytical tools to address documentation-improvement alerts.

• Work with coding partners to finalize OASIS workflows.

• Acquire additional provider or facility records to enhance the accuracy of plans of care and OASIS documentation.

• Raise documentation-improvement opportunities with supervisors and leadership.

⛳️ Requirements

• At least two years of experience in home health, specifically in quality, supervisory, or staff development roles.

• Must be a licensed RN or PT in good standing from an accredited program.

• Professional license, certificate, or registration must be maintained in good standing.

• Strong preference for candidates with OASIS and coding experience.

• HCHB experience is preferred.

• Certification in ICD Coding/OASIS is preferred.

• Excellent organizational skills and attention to detail are essential.

• Strong verbal and written communication skills combined with leadership capabilities.

• Ability to work independently.

• Capability to work on a computer for extended periods to review documentation and workflows.

• Successful completion of a pre-employment drug screening is required.

• Must be legally authorized to work in the United States.

🏝️ Benefits

• Medical benefits including health, vision, and dental insurance.

• 401(k) and pension plan with a 4% employer contribution.

• 15 days of paid time off (PTO).

• Company-paid life insurance.

• Company-paid disability benefits.

• Pre-tax FSA and HSA plans available.

• 50% tuition discounts for selected Purdue and Kaplan courses.

• Opportunities for advancement.

• Fully remote work arrangement.