Requisition: 2023-129419

　　Utilization Review RN - Home Health (Remote)

　　Job LocationsUS-KY-LOUISVILLE

　　Our CompanyAdoration Home Health and Hospice

　　OverviewAdoration Home Health is currently seeking a Utilization Review RN - Registered Nurse to support our home health operations throughout multiple regions of the country.

　　ResponsibilitiesThe Home Health Utilization Review Specialist (URS) conducts Utilization Review and ICD-10 Coding activities for area of responsibility, complying with company's policies and procedures. Assists company in ensuring accurate OASIS and ICD-10 coding recommendations per coding regulations and guidelines, as well as excellent clinical outcomes

　　Works with all assigned locations to ensure accurate ICD-10 coding and a modified OASIS review is completed per the company's policies and proceduresReviews OASIS assessment documents and ICD-10 coding and provides feedback to clinical staff regarding areas in need of improvement relating to clinical documentation that accurately reflects the patients condition and needs to support payer requirementsWorks with management as requested to develop and implement best practices for documentation and coding of Home Health and Hospice servicesProvides staff training for new Utilization Review initiatives and monitors the performance of assigned branchesParticipates in the development of company Utilization Review guidelines and protocolsPrepares and provides reporting on ICD-10 coding and OASIS reviews. Identifies clinical strategies for impacting branch OASIS and ICD-10 coding and makes recommendations for changes to policy, practices and processesCollaborates with necessary management teams to develop clinical strategies and implements processes and practices that achieve the company's clinical and financial objectivesKeeps abreast of pertinent industry utilization, coding and OASIS coding practice standardsParticipates in educating branch and regional staff in best documentation practices and protocols of care that drive both excellent clinical outcomes, as well as ensuring accurate financial reimbursement for services providedIdentify problems and follows up as needed with appropriate staff; responds timely to answer and/or resolve any coding or OASIS review questionsEstablishes and promotes positive, ongoing communication with company personnel

　　QualificationsCurrent Registered Nurse licensure required; Bachelors degree preferredCurrent ICD-10 Home Health coding certification required; must be maintainedCurrent OASIS Home Health certification required; must be maintainedFive years of professional experience preferred in Home Health and/or HospiceExcellent understanding of OASIS and ICD-10 coding practices, along with a strong knowledge of Home Health and/or Hospice regulationsDemonstrates excellent verbal, written, and critical thinking skills; must be able to be proactive and work well under pressure to meet deadlines and company needsDemonstrates organizational and multi-tasking skills, as well as professionalism and discretion, with the ability to get along well with others in a work environment; must also demonstrate the ability to work independently; must be proactive, responsive and resourcefulProficient in basic computer skills and Word; must read, write and speak fluent EnglishMust possess the ability to work a flexible schedule and extended hours on occasionMust have current drivers license and have reliable transportation and insurance

　　About our Line of BusinessAdoration Home Health and Hospice provides quality and compassionate services in the comfort of home, providing support for patients, families and caregivers in their time of need. Adoration was formed to fill the need for a loving, community-focused, caring organization. We empower patients to live with dignity, find a sense of fulfillment, and celebrate with their families a life well-lived. Our employees and caregivers are proud to be a part of the Adoration team and the mission of our company. For more information about Adoration, please visit www.AdorationHealth.com. Follow us on FacebookandLinkedIn.

　　Additional Job InformationOasis Registered Nurse - Oasis RN

　　Salary RangeUSD $76,000.00 - $84,000.00 / Year

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　　Res-Care, Inc., dba BrightSpring Health Services (“ResCare”), is an Equal Opportunity Employer. ResCare does not discriminate against any person on the basis of gender, r ace, color, national origin, r eligion, disability, age, veteran status, gender identity or s exual orientation in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of gender in its health programs and activities.