Clinical Record Reviewer (RN) - Home Health Remote

1004 Lehigh Valley Hospital; Bird in Hand (PA); Remote; USD 60,000 - 80,000; Full time

Job summary

Join a leading health network as a Clinical Record Reviewer (RN) overseeing home health documentation. This role emphasizes quality improvement, compliance with medical guidelines, and collaboration with healthcare teams. If you have a passion for excellence in patient care and nursing, this opportunity is ideal for you.

Qualifications

• 2 years experience as a Registered Nurse.
• Ability to work cross functionally across remote teams.
• Knowledge of Medicare guidelines for hospice coverage.

Responsibilities

• Reviews patient records to ensure accurate documentation.
• Consults with providers to ensure consistency in clinical criteria.
• Manages quality improvement plans and outcome data collection.

Skills

Clinical expertise

Documentation compliance

Quality improvement

Education

Associate’s Degree in Nursing

Job description

Clinical Record Reviewer (RN) - Home Health Remote page is loaded

Clinical Record Reviewer (RN) - Home Health Remote

Apply locations Pennsylvania - Remote time type Full time posted on Posted 2 Days Ago job requisition id JR121159

Imagine a career at one of the nation's most advanced health networks.

Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work.

LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day.

Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network.

CLINICAL RECORD REVIEWER (RN) HOME HEALTH

OASIS and Diagnosis Coding Experience strongly preferred

Summary
Manages and supports quality and performance improvement by assisting staff to implement strategies that identify, prioritize, measure, and improve key clinical processes and outcomes. Reviews patient records to determine the complete, accurate, and timely documentation of all conditions that support home health/hospice care and treatment of the patient.

Job Duties

• Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care
• Consults with providers, management, and operations to ensure consistency within the application of clinical criteria
• Utilizes clinical expertise for the review of medical records against appropriate criteria in conjunction with contract requirements
• Maintains current knowledge of clinical indicators and compliance requirements
• Manages tools to collect outcome data and provides regular feedback to individuals, managers, and leaders
• Provides concurrent medical record review to assess documentation compliance. Facilitates recommended interventions
• Reviews deficiencies in documentation with involved staff and facilitates corrective action
• Participates in the ongoing development and implementation of an established performance improvement plan
• Reviews orders for data entry, completeness, and appropriateness for admission to home health/hospice services
• Promotes, obtains, and reviews appropriate documentation for any home health/hospice specific quality data

Minimum Qualifications

• Associate’s Degree in Nursing.
• 2 years Experience as a Registered Nurse.
• Ability to work cross functionally across remote teams.
• Demonstrates a working knowledge of Medicare guidelines for hospice coverage.
• Demonstrated track record of continuous quality improvement.
• Proficient in prioritizing work and delegating where indicated.
• HCS-D - Home Care Coding Specialist-Diagnosis - Board of Medical Specialty Coding and Compliance Within 1 Year or
• HCS-O - Home Care Clinical Spec-OASIS - Board of Medical Specialty Coding and Compliance Within 1 Year or
• COS-C - Certificate OASIS Specialist-Clinical - OASIS Certificate & Competency Board Within 1 Year and
• RN - Licensed Registered Nurse_PA - State of Pennsylvania Upon Hire

Preferred Qualifications

• Bachelor’s Degree in Nursing.
• 2 years Hospice experience and
• 1 year Hospice documentation experience or
• 2 years Home Care experience and
• 1 year Home Health OASIS documentation or
• 1 year ICD-9/ICD-10 coding experience
• HCS-D - Home Care Coding Specialist-Diagnosis - Board of Medical Specialty Coding and Compliance Upon Hire or
• HCS-O - Home Care Clinical Spec-OASIS - Board of Medical Specialty Coding and Compliance Upon Hire or
• COS-C - Certificate OASIS Specialist-Clinical - OASIS Certificate & Competency Board Upon Hire

Physical Demands
Lift and carry 25 lbs. frequent sitting/standing, frequent keyboard use, *patient care providers may be required to perform activities specific to their role including kneeling, bending, squatting and performing CPR.

Job Description Disclaimer: This position description provides the major duties/responsibilities, requirements and working conditions for the position. It is intended to be an accurate reflection of the current position, however management reserves the right to revise or change as necessary to meet organizational needs. Other responsibilities may be assigned when circumstances require.

Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities.

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Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location. Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes.

Work Shift:

Day Shift

Address:

1200 S Cedar Crest Blvd

Primary Location:

REMOTE IN PENNSYLVANIA

Position Type:

Remote

Union:

Not Applicable

Work Schedule:

Monday-Friday 8-430p Remote

Department:

1004-09187 Health Center Central Business Office - CC

Why work here?

Lehigh Valley Health Network (LVHN) is the region’s largest employer and health care provider of choice. Our nearly 20,000 health care professionals take pride in what they do and are driven by our mission to heal, comfort and care for the people of our community.

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About Us

LVHN is honored to be certified as a Great Place to Work. LVHN’s culture of trust – and the positive things colleagues said about working at LVHN when surveyed by Great Place to Work and Fortune – align perfectly with what makes a great workplace.

This designation tells you that LVHN is a great place to work from hire to retire. If you are someone who aligns with LVHN’s core values – Compassion, Integrity, Collaboration and Excellence – you will have a rewarding and successful career here.