Part Time RN Home Health Consultant estimated 30-40 hours/month

Job Description

Job Description

Part time RN Home Health Consultant estimated 30-40 hours/month.

Within 1-hour circumference of Indianapolis preferred.

For mock survey, client onsite support, preparation for ACHC/CHAP and state survey for client Home Health Agencies, QA reviews. New start up support, leadership training, operational process implementation, clinical programs, training/development for field clinicians. Strong background in OASIS and Medicare conditions of participation preferred. Past background as a Home Health Administrator or Clinical Director strongly preferred.

The Home Health Consultant is a Registered Nurse who has primary responsibility for clinical documentation review, maintaining compliance with licensure/certification and accreditation requirements and agency policies and procedures.

The Home Health Consultant provides experienced operational, clinical, regulatory, and administrative support to home health agencies seeking to improve performance, strengthen compliance, enhance documentation, and maintain survey readiness. The consultant applies comprehensive knowledge of Medicare Conditions of Participation, state requirements, payer expectations, clinical operations, documentation standards, quality improvement, and home health business processes.

Depending on the engagement, the Home Health Consultant may serve in an advisory role, assisting the agency to develop systems, orient facility staff new to the QA role, and/or facilitating clinical reimbursement focused QAPI initiatives. The Home Health Consultant will provide expertise to Agencies assigned for ICD-10 coding, reviewing OASIS, Plan of Care review, process & outcome measures, Star Rating items and all pertinent documentation to ensure accurate coding for each patient and ensures that all applicable Federal laws are followed. Applied knowledge of medical terminology, disease processes, and pharmacology required. This individual will be required to make independent decisions regarding accurate ICD10-CM code assignments, OASIS, and Plan of Care (POC) recommendations. The Home Health Consultant will proficiently assist agencies with QAPI audits and ADR audits and appeals as indicated. The Home Health Consultant will play a key role in determining the reimbursement of the agency to which they are assigned and adherence to coding standards and regulations and corporate policies developed to ensure accurate billing. The Home Health Consultant will maintain strong knowledge of PDGM guidelines, Conditions of Participation and CMS guidelines for home health.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

1. Evaluate overall home health operations and identify compliance, clinical, financial, and operational risks.
2. Review and improve agency policies, procedures, workflows, forms, and operational processes.
3. Assist agencies with ACHC, CHAP, state, and other accreditation/survey readiness.
4. Assist leadership with identifying opportunities for improved efficiency, profitability, staff retention, and patient outcomes.
5. Evaluate referral, intake, admission, scheduling, staffing, clinical, billing, and discharge workflows.
6. Provide education and mentoring to administrators, directors of nursing, clinical managers, clinicians, intake staff, billing staff, and other personnel.
7. Provide support for ADR, TPE, UPIC, payer audits, and other medical-record requests.
8. Support development and implementation of QAPI programs, performance improvement projects, dashboards, and monitoring tools.
9. Provide recommendations and written action plans to agency leadership.
10. Review all OASIS assessment documents and ICD 10 codes for accuracy, consistency, appropriateness and supporting documentation.
11. Review supporting documentation for accuracy and completeness and ensures readiness for billing.
12. Review clinical charting for conformance/compliance to Medicare and Agency guidelines.
13. Review clinician OASIS in collaboration with the assessing clinician for Billing.
14. Creation of Plan of Care documents in accordance with Medicare Standards and CMS guidelines.
15. Upload coding recommendations into the charting software and enter the supplied codes into the appropriate OASIS document.
16. Provide OASIS-E documentation training for all new clinical team members.
17. Provides appropriate documentation and OASIS education as indicated.
18. Maintain professional knowledge of evolving Medicare, Medicaid, state, accreditation, and payer requirements.
19. Discusses any noted documentation discrepancies with Clinical Supervisors and clinical staff as appropriate (or designated contact personnel for assigned agencies)
20. Perform QAPI/ADR chart audits assigned by the Principal Consultant of Home Health.
21. Perform agency Mock surveys (in-person/remote) as assigned by the Principal Consultant of Home Health.
22. Participate in staff meetings, in services and seminars.
23. Do other activities as deemed necessary by the Principal Consultant of Home Health.
24. Participate in ongoing education as required for efficiency in role
25. Stay up to date with OASIS and Coding updates, CoPs, PDGM, VBP, and Medicare/CMS standards for home health.

RECOMMENDED MINIMUM POSITION QUALIFICATIONS:

• Must be a registered nurse (RN) with 3-5 years minimum of Home Health Operational Experience
• Demonstrated experience in home health operations, clinical leadership, administration, compliance, or consulting.
• Strong knowledge of home health documentation and regulatory requirements.
• Ability to interpret regulations and translate requirements into practical agency workflows.
• Ability to educate, coach, and mentor agency leadership and clinical staff.
• Knowledgeable of home health Reimbursement and Billing Regulations, including but not limited PDGM and VBP.
• Proficient in assigning ICD-10-CM codes.
• Strong skills in care plan development
• Current State Licensure/Certification in good standing
• Strong organizational skills with the ability to coordinate multi-site projects, prioritize obligations, and consistently meet deadlines.
• Regular Attendance.
• Excellent ability to interact and develop professional advisory relationships including skills in verbal communication with a demonstrated ability to share constructive feedback in a manner that motivates growth.
• Competence in interpreting data related to reimbursement and quality trends and providing succinct analysis and pragmatic action plans to drive performance improvement.
• Sound computer skills and continually updates knowledge related to computer technology and is currently proficient in Microsoft Office including PowerPoint, Word, and Excel; experienced users of commonly used home health software platforms are preferred, such as, but not limited to: Home Care Home Base, MatrixCare, Wellsky and Netsmart/Allscripts.
• Willingness to travel as needed by clients.

Physical Requirements and Working Conditions:

• Work in well-lighted/ventilated office areas, as well as throughout the nursing service areas
• Dependable access to home offices and high-speed internet is required.
• Sitting, standing, bending, lifting, and moving intermittently during working hours
• Extensive computer work
• Subject to frequent interruptions
• May be required to lift patients, medical equipment, and supplies.
• Is subject to exposure to infectious waste, diseases, and conditions, including tuberculosis and the AIDS/HIV and hepatitis B and other viruses
• Must possess sight/hearing senses or use prosthetics that enable these senses to function adequately so that the requirements of this position can be fully met.

The essential functions described here are representative of those an employee encounters while performing the basic functions of a Home Health Consultant. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.