HOW WE CARE FOR YOU:

At Rochester Regional Health, we are dedicated to getting health care right. Our robust benefits and total rewards foster employee wellbeing, professional development and personal growth. We care for your career while caring for the community.

Paid Time Off & HolidaysRelocation AssistanceBenefits Effective Date of HireTuition Assistance & Student Loan ForgivenessEmployee Referral ProgramEmployee Assistance ProgramSame Day Pay through Daily Pay401k and Company MatchingEmployee Discounts

SUMMARY

Under the direction of Leadership, coordinates/performs all activities related to the RRHS utilization review (UR) program and quality record documentation monitoring. A primary responsibility of this position (in addition to chart review for UR) is the timely review/approval of Start of Care Assessments including the Comprehensive Assessment, Physician Plan of Care, OASIS, and home health diagnosis coding. Reviews clinical documentation to ensure adherence to State and Federal regulations, payer requirements, and OASIS CMS guidance. Provides superior customer service by modeling the Brand Promise and the Core Values.

STATUS: Full Time          

LOCATION: 330 Monroe Ace Rochester, NY        

DEPARTMENT: Quality Management

SCHEDULE: Monday- Friday; Days 8 to 430pm

        

ATTRIBUTES

Bachelor’s Degree in Physical Therapy, Occupational Therapy, or Speech Language Pathology; Master’s Degree preferred2-4 years of home care experienceCOS-C certification preferred.Home Health Diagnosis Coding Certification preferred.1 year of home care quality/regulatory experience preferred.1 year of OASIS experience preferred

RESPONSIBILITIES

Responsible for ongoing documentation and chart audit: to include but not limited to home health diagnosis coding, OASIS Start of Care, Resumption of Care, Recertification, and Discharge chart audits, 485 audits, Plan of Corrections audits, compliance audits, etc.Responsible for maintaining current knowledge of home health diagnosis coding and OASIS review. Participates in educational opportunities provided to the team. Responsible for the Quarterly Utilization and Review (U/R) process to include timely completion of required number of audits, documentation of audit results.Participates in the ongoing regulatory review, identifies and researches new regulations as assigned. - Participates in the organizations policy and procedure review process as assigned.Develops new policies as assigned.Performs inter-rater visits as requested by leadershipParticipates in education of staff to include but not limited to quality initiatives, OASIS in-services, Policy and Procedures, Orientation.Facilitates and/or participates in ongoing committees or groups.Represents the organization to appropriate Community Groups.Collaborates with clinical practice and education nurse to ensure all quality and compliance activities are coordinated and based on data.Performs co-visits or billable patient visits as needed, as requested by leadership.Other duties as assigned

EDUCATION:

LICENSES / CERTIFICATIONS: 

PHYSICAL REQUIREMENTS:

M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$60,500.00 - $85,000.00

CITY:

Rochester

POSTAL CODE:

14607

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity/Affirmative Action Employer.
Minority/Female/Disability/Veterans by a prospective employee and/or employee’s Physician or delegate will be considered for accommodations.