Job Description

Position PurposePurpose TextThe purpose of this position is to improve compliance and outcomes at Home Health by ensuring that the medical record is complete and accurate. In addition, this position ensures that the OASIS (Outcome and Assessment Information Set) clearly represents the patient\xe2\x80\x99s condition at the time completed. Working with coding, this clinician will ensure that the diagnosis meets government compliance standards. The records will meet all standards for timing of submission of OASIS and Plan of Care. This team will monitor, report, and develop actions to optimize reimbursement and star ratings measures.
Nature and ScopeNature and Scope TextThe Home Health Outcomes Specialist reviews and analyzes health records to identify relevant diagnoses and procedures pertinent to the Home Health episode. The clinician reviews the OASIS document for accuracy and consistency utilizing learned skills as well as expertise with the OASIS scrubbing software. The clinician ensures that all mandated process measures are addressed appropriately and that the Plan of Care is complete and sent to the physician within mandated time frames. The clinician pre-codes the charts according to assessments documented by the field clinicians. The coded information that is a product of the coding process is then utilized for reimbursement purposes and the determination of care.The clinician must have a thorough understanding of the content of the medical record in order to be able to locate information to support or provide specificity for the appropriate diagnosis code. The clinician must be trained in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded. The clinician works as a part of a coding team to achieve and ensure that there is no coding disagreement with the DRG/HHRG.The clinician must be skilled at teaching and giving feedback to others. The clinician is clinically competent, an expert at OASIS documentation and compliance, and provides education to field staff regarding correction OASIS procedure. The clinician must be expert in the specifics of physical assessment for the OASIS process as well as all agency initiatives. The team will maintain quality improvement data on all the OASIS time points and develop action plans to improve outcomes. This will drive improvement in process and care.This position is challenged to be aware of the continual changes in Federal and State regulations for prospective payment, keep informed of changes in treatment modes and new procedures, and to clarify diagnoses when physician documentation is vague or missing.This position does not provide patient care.DisclaimerThe foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum QualificationsRequirements - Required and/or Preferred MinQualName DescriptionEducation:Must have working-level knowledge of the English language, including reading, writing, and speaking English.Experience:Minimum 5 years of clinical experience. Home Health experience strongly preferred.License(s):Ability to obtain and maintain a State of Nevada Registered Nurse, Physical Therapy, or Occupational Therapy license.Valid CA or NV Driver\'s license and ability to pass Renown Health\'s Department of Motor Vehicle Report criteria. Current auto insurance.Required for this position Fingerprints must be able to pass Nevada Division of Public and Behavioral Health (DBPH) background checks upon hire and every 5 years per State of Nevada Revised Statue (NRS 449.123) to remain in this position.Certification(s):Current CPR certification by AHA standards, required at time of hire.Ability to obtain and maintain National OASIS Certification within 6 months of hire.Computer / Typing:Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.Nature and ScopeThe Outcomes Specialist reviews and analyzes health records to identify relevant diagnoses and procedures pertinent to the Home Health episode. The clinician reviews the OASIS document for accuracy and consistency utilizing learned skills as well as expertise with the OASIS scrubbing software. The clinician ensures that all mandated process measures are addressed appropriately and that the Plan of Care is complete and sent to the physician within mandated time frames. The clinician pre-codes the charts according to assessments documented by the field clinicians. The coded information that is a product of the coding process is then utilized for reimbursement purposes and the determination of care.The clinician must have a thorough understanding of the content of the medical record in order to be able to locate information to support or provide specificity for the appropriate diagnosis code. The clinician must be trained in the anatomy and physiology of the human body and disease processes in order to understand the etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and prognosis of diseases and procedures to be coded. The clinician works as a part of a coding team to achieve and ensure that there is no coding disagreement with the DRG/HHRG.The clinician must be skilled at teaching and giving feedback to others. The clinician is clinically competent and will spend time in the field observing clinical practice and documentation, as well as demonstrating correct procedure. The clinician must be expert in the specifics of physical assessment for the OASIS process as well as all agency initiatives. The team will maintain quality improvement data on all the OASIS time points and develop action plans to improve outcomes. This will drive improvement in process and care.This position is challenged to be aware of the continual changes in Federal and State regulations for prospective payment, keep informed of changes in treatment modes and new procedures, and to clarify diagnoses when physician documentation is vague or missing.This position does not provide patient care.DisclaimerThe foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.Minimum Qualifications
Requirements - Required and/or PreferredNameDescriptionEducation:Must have working-level knowledge of the English language, including reading, writing, and speaking English.Experience:Minimum 5 years of nursing experience / area of specialty practice in working as an RN is required. Knowledge of the ICD system preferred.License(s):Ability to obtain and maintain a State of Nevada Registered Nurse license.Valid CA or NV Driver\'s license and ability to pass Renown Health\'s Department of Motor Vehicle Report criteria. Current auto insurance.Required for this position Fingerprints must be able to pass Nevada Division of Public and Behavioral Health (DBPH) background checks upon hire and every 5 years per State of Nevada Revised Statue (NRS 449.123) to remain in this position.Certification(s):Current CPR certification by AHA standards, required. CCDS Certification PreferredWithin Six Months-National OASIS CertificationComputer / Typing:Working knowledge of basic computer programs and Microsoft Office Suite. Keyboard typing required.Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

Renown Health