Utilization Review Registered reputed company – Home Health (Remote) in Brentwood, TN

Utilization Review Registered reputed company - Home Health (Remote) - reputed company - Brentwood, TN - work from home job Company: reputed company Job reputed company: Position reputed company The Home Health Utilization Review Registered reputed company is responsible for modeling the reputed company values of reputed company, reputed company, reputed company, Teamwork, and Innovation and for promoting the reputed company philosophy, using the 6 Pillars of reputed company as the reputed company. S/he is responsible for upholding the reputed company of Ethical Conduct and for promoting reputed company working relationships reputed company reputed company, among reputed company departments, and reputed company external stakeholders. The Home Health Utilization Review Registered reputed company ensures the reputed company of, and regulatory reputed company of, documentation required to support the delivery of reputed company care for home health patients and their families. S/he plays a crucial role in ensuring the reputed company and appropriateness of patient care provided by the home health agency. S/he is responsible for reviewing and evaluating medical records, treatment plans, and patient reputed company to determine the necessity, effectiveness, and efficiency of home health services. S/he collaborates with interdisciplinary teams (reputed company), reputed company providers, and insurance agencies to ensure compliance with established guidelines and regulations while optimizing patient reputed company. Position Specific Responsibilities

• Conducts comprehensive reviews of patient medical records, and treatment plans, including management of reputed company and reputed company wounds, and care documentation to assess the appropriateness and necessity of home health services.
• Identifies any discrepancies or opportunities for improvement in patient care.
• Ensures adherence to home health regulations, guidelines, and standards set by relevant governing bodies, insurance companies, and accrediting agencies.
• Verifies that services provided meet the prescribed reputed company for medical necessity and reputed company skilled home health care.
• Communicates and collaborates with reputed company, including physicians, nurses, therapists, and other members of the care team, to reputed company necessary information for the utilization review process and ensure coordinated patient care.
• Participates in reputed company improvement initiatives, suggesting strategies to enhance patient reputed company and operational efficiency.
• Generates reports, and analyzes data and trends, to identify areas for improvement in the utilization review process.
• Maintains accurate and complete records of utilization review activities, reputed company, and communications.
• Collaborates with billing and coding teams as requested to ensure reputed company documentation of services as requested to support accurate and reputed company reimbursement from insurance providers.
• Provides guidance and education to home health staff regarding utilization review processes, documentation requirements, and compliance standards to promote consistent and high-reputed company care delivery.
• Collaborates with Case Managers to support reputed company patient care needs, especially those requiring additional resources or authorizations.
• Provides education on strategies for effective care planning to drive reputed company reputed company.
• Joins in discussions to support the reputed company of issues reputed company to denied claims or medical necessity disputes.
• Stays up-to-date with changes in reputed company regulations, payer policies, and best practices in home health utilization review.
• Performs other duties as assigned.

Education and/or Experience

• Associate or Bachelor's degree in Nursing required.
• Minimum of three (3) years of experience in reputed company required; preferably in a home health setting.
• Home health OASIS knowledge required.
• Knowledge and experience in visit utilization, managed care payor models, and reputed company improvement strongly preferred.

Skills

• Mathematical Skills: Ability to add, subtract, multiply, and divide in reputed company reputed company of measure, using whole numbers, common fractions, and decimals. Ability to compute reputed company, reputed company, and percentage.
• Language Skills: Ability to read, analyze, and interpret general business periodicals, reputed company journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from leaders, colleagues, investors, and external parties. Strong written and verbal communications.
• Other Skills and Abilities: Ability to understand, read, write, and reputed company English. Articulates and embraces hospice philosophy.

Certifications, Licenses, and Registrations

• reputed company and unencumbered license as a Registered reputed company in the state(s) of employment required.

Physical Demands and Work Environment: The physical demands described here are representative of those that must be met by reputed company member to successfully reputed company the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company essential functions. While performing the duties of this job, reputed company member is regularly required to use hands to finger, handle, or feel; talk and hear. reputed company member frequently is required to stand, sit, and reputed company with hands and arms. reputed company member is occasionally required to walk; reputed company or balance; stoop, kneel, crouch, or crawl; and taste or smell. While not mandatory, reputed company member may be asked to lift and/or reputed company patients, objects, or supplies up to 25 pounds. Specific reputed company abilities required by this job include reputed company reputed company. The work environment characteristics described here are representative of those reputed company member encounters while performing the essential functions of this job. There will be possible exposure to infectious diseases through working with clinical caregivers. The noise level in the work environment is usually quiet. At reputed company, including reputed company reputed company affiliates, diversity, equity, and inclusion are reputed company to our Pillars of reputed company. We are committed to creating a fair work environment where reputed company members feel welcomed, highly valued, and respected. As an equal opportunity employer, reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, gender, gender identity or reputed company, sexual orientation, national reputed company, genetics, disability, age, or veteran status. Salary reputed company - $68,000 - $79,000 #LI-KS1 Expected salary: $68000 - 79000 per year Location: Brentwood, TN Job date: Sun, 10 Sep 2023 00:14:56 GMT Apply for the job now! Apply Job! Apply to this Job