Clinical Reimbursement Partner Home Health Care

Clinical Reimbursement Partner Home Health Care

The targeted pay range for this job is $100,000 - $115,000 annually. Ecumen considers a variety of factors when determining new hire pay including experience, qualifications, and, when applicable, certifications, licenses, and education.

Benefits:

Ecumen offers a comprehensive benefits package to our full-time team members including medical, dental, vision, flexible spending and health savings accounts, life & disability insurance, paid time off benefits (PTO, Sick & Safe Time, and paid holidays), a generous 6% 401(k) match, and other well-being resources. Learn more at https://www.ecumen.org/find-a-career/benefits/.

You'll also enjoy the convenience and flexibility of working remote with the ability to travel up to 20% throughout the state of Minnesota.

The Clinical Reimbursement Partner position is responsible for optimizing reimbursement from all Home Care payer sources, conducting multi-site revenue analyses, and synthesizing corporate data. This position is responsible for being the subject matter expert in OASIS documentation, mitigating/preventing takebacks through action planning, and improving organizational processes. This position is also responsible for identifying gaps and address barriers to OASIS accuracy, targeting Quality Measure improvements, and providing education and resources to enhance OASIS workflows and organizational knowledge.

About Us:

Ecumen is an industry leader dedicated to advocating for older adults by providing housing choices, compassionate healthcare, and innovative services. For 160 years Ecumen has cared for those in need. Now, as Minnesota's 8th largest senior living provider, we continue to advocate for those we serve. Join a team where you can make a difference in advancing our mission to serve our older adults, while we commit to creating a place where everyone belongs.

Essential Job Responsibilities:

1. Leads the clinical reimbursement practices for Home Health Agencies through oversight of OASIS practices across the organization.
2. Ensures OASIS clinical processes meet all applicable regulatory requirements and industry best practices.
3. Develops and recommends process flows for Home Health that enhance efficiency and maximize reimbursement potential.
4. Provides ongoing education, orientation, and resources to Home Health Clinical Directors and other clinicians and acts as the subject matter expert on technical OASIS processes.
5. Ensures standardized, optimized OASIS coding to maximize OASIS reimbursement, maintain regulatory compliance and decrease organizational risk.
6. Conducts and supervises documentation audits to ensure accuracy, compliance, and alignment across all home health sites.
7. Provides back-up support with Quality Assurance as needed across the home health sites.

Clinical Reimbursement Partner Home Health Care Minimum Required Qualifications:

• Associate's Degree in Nursing
• Must be licensed as a Registered Nurse within the state in which working and must maintain licensure Practical experience with relevant clinical systems
• 3 years of experience in healthcare, clinical quality and reimbursement, and healthcare compliance
• Strong knowledge of Medicare regulations and reimbursement methodologies
• Ability to communicate effectively in both verbal and written formats
• Proficient with Microsoft Office Suite
• Able to follow all safety rules, regulations, policies and procedures of the facility including but not limited to: Vulnerable Adult and Abuse Policy, HIPAA, Resident's Bill of Rights, Universal Precaution, AWAIR, OSHA, Right to know, SDS, ADA, HUD Policy and Procedures, Fair Housing laws and regulations

Preferred Qualifications:

• Bachelor's Degree in Nursing
• OASIS Certified
• Experience in conducting clinical audits and implementing quality improvement initiatives