Netsmart

A healthcare software company helping you deliver whole-person, value-based care.

Clinical Consulting Manager, PRN

ManagerManagerPart TimeRemoteTeam 1,001-5,000Since 1973H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

8 days ago

Salary

Not specified

Associate Degree5 yrs expEnglish

Job Description

• Perform documentation review on medical records to identify clinical elements for accuracy • Perform post-acute home health and or hospice documentation review on medical records to identify clinical elements for accuracy • Research and provide comments and recommendations on complex or newly issued home health and or hospice billing regulations • Review client information systems for complete and accurate clinical documentation • Research and provide comments and recommendations on complex or newly issued billing regulations • Conduct weekly calls with the client to present findings and results of the engagement • Analyze trends and provide process improvement recommendations for clinical operational processes to improve quality of care and patient outcomes • Review documentation associated with focused medical reviews and write appeals for denied services; provide denial support at the Administrative Law Judge (ALJ) level of appeals • Participate in cross-team clinical consulting work

Job Requirements

  • Associate’s Degree in nursing, social work, physical therapy or another related discipline
  • Active and unrestricted license in related field
  • At least 5 years of progressive clinical management experience
  • At least 2 years case management in home health and/or hospice with progressive experience in Quality Assurance activities
  • In-depth knowledge of condition of participations and conditions of payment; extensive knowledge of regulatory standardized assessment documents and patient care protocols
  • Proficient in Microsoft Office Suite including Excel, PowerPoint, and Word
  • Excellent written and verbal communication and presentation skills are required

Benefits

  • Netsmart is proud to be an equal opportunity workplace
  • Affirmative action employer
  • Equal employment opportunities to all individuals
  • Celebrate diversity and committed to creating an inclusive environment

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