Oasis Reviewer

Mosai; Nashville (TN); Hybride; USD 85 000 - 110 000; Plein temps

Résumé du poste

Mosai is seeking an experienced registered nurse to perform clinical review and validation of OASIS assessments for home health clients. You will verify platform findings against source records, apply PDGM rules, and provide defensible written recommendations within defined turnaround times.

This production review role is not client-facing; you will work remotely or in a hybrid setting with access to client EMRs and Mosai’s AI-assisted platform.

Qualifications

• Active, unrestricted RN license in required states.
• Strong written communication and attention to detail.
• Ability to work independently in a remote environment while meeting daily throughput targets.
• Experience with OASIS reviews and PDGM concepts preferred.

Responsabilités

• Conduct review using Mosai’s AI-assisted review platform, verifying every platform finding against the record.
• Review OASIS assessments across time points (Start of Care, Resumption of Care, Recertification, Transfer, Discharge) for accuracy.
• Verify consistency between OASIS responses and supporting records, focusing on Section GG, cognitive/behavioral items, and M-items.
• Apply PDGM requirements including clinical grouping and functional impairment levels.
• Review primary/secondary diagnoses against ICD-10 guidelines and sequencing conventions when applicable.
• Produce written, non-leading recommendations with documentation and rationale.
• Enter recommendations through client channels, meet turnaround commitments, and track to closure.
• Work across multiple client EMR systems and complete onboarding for each client.
• Maintain HIPAA compliance and protect PHI; avoid altering documentation.
• Maintain high quality standards and participate in calibration exercises.
• Hybrid role based in Nashville or Jacksonville; occasional travel for training.

Connaissances

Written communication

Attention to detail

Independent work

Critical thinking

Formation

Associate’s degree in Nursing

Outils

Homecare Homebase

WellSky

Axxess

KanTime

Description du poste

Mosai™ is the intelligent care coordination platform that brings together the fragmented pieces of healthcare into a clear, connected picture. Like a mosaic, our platform unites data, people, and processes so providers can make better decisions, coordinate care in real time, and deliver improved outcomes. With Mosai, home-based care organizations can thrive in value-based care while giving every patient the right care, in the right place, at the right time. Learn more at https://www.mosai.com/

Position Summary

• Performs clinical review and validation of OASIS assessments on behalf of contracted home health agency clients, working within Mosai’s AI-assisted review platform and each client’s electronic medical record.
• Applies licensed clinical judgment to independently verify platform-generated findings against the source record and produce clear, defensible recommendations.
• May be assigned ICD-10 coding review as a secondary scope, based on credentials held and the services a given client has purchased.
• This is a production review role and is not client-facing; all questions, disagreements, and escalations route through Mosai clinical operations and the client services team.

Job Duties:

• Conduct review using Mosai’s AI-assisted review platform, accessing source documentation in the platform and the client’s EMR as the assignment requires; independently verify every platform-generated finding against the record before including it in a recommendation.
• Review OASIS assessments across all required time points: Start of Care, Resumption of Care, Recertification, Transfer, and Discharge - validating responses against the current OASIS data set, CMS Guidance Manual, applicable skip logic, and CMS Quarterly OASIS Q&As.
• Verify internal consistency between OASIS responses and the supporting record, applying particular scrutiny to Section GG self-care and mobility items, cognitive and behavioral items, and case-mix-impacting M-items.
• Apply Patient-Driven Groupings Model (PDGM) requirements, including clinical grouping, functional impairment level, comorbidity adjustment, and LUPA exposure.
• Where credentialed, review primary and secondary diagnosis assignment against ICD-10-CM Official Guidelines and home health sequencing conventions as a secondary scope, escalating coding or OASIS conflicts to Mosai clinical operations.
• Produce written recommendations that state the item or code at issue, the supporting or conflicting documentation and its location in the record, applicable CMS or coding guidance, and clinical rationale — framed as compliant, non-leading requests that never direct a specific response.
• Enter recommendations through each client’s defined channel, meet contracted turnaround commitments, and track recommendations to closure.
• Work across multiple client agencies and EMR platforms, completing client-required onboarding and access provisioning before beginning review work for that client.
• Access and use protected health information only as necessary to perform assigned review work, consistent with HIPAA minimum necessary requirements and the applicable Business Associate Agreement; never enter, alter, or fabricate clinical documentation.
• Maintain review accuracy at or above the standard defined by Mosai clinical quality, participate in calibration exercises, and report platform false positives, missed findings, and out-of-date guidance references.
• Active, unrestricted Registered Nurse (RN) license required, in the state or states necessary to support assigned client work.
• Associate’s degree in Nursing required.
• Current COS-C (Certificate for OASIS Specialist – Clinical) or HCS-O (Home Care Clinical Specialist – OASIS) certification required, held at time of hire.
• Minimum of 3 years of clinical experience in Medicare-certified home health required, including hands-on completion or review of OASIS assessments.
• Hands-on experience with at least one major home health EMR (for example Homecare Homebase, WellSky, Axxess, or KanTime) required.
• Demonstrated working knowledge of PDGM, HIPPS and case-mix assignment, LUPA thresholds, CMS Conditions of Participation, and OASIS-based quality measures.
• Ability to critically evaluate AI-generated findings and disagree with the platform when the record does not support it; strong written communication, high attention to detail, and the ability to work independently in a remote environment while meeting daily throughput targets.
• This is a hybrid role based in Nashville or Jacksonville.
• Primarily sedentary work performed in a remote or office setting, with extended periods of computer and screen use.
• This is a production review role and is not client-facing; all questions and escalations route through Mosai clinical operations and the client services team.
• Remote work requires a secure, private workspace and a reliable internet connection meeting Mosai and client security standards.
• Occasional travel for training or team meetings; no client site visits required.
• All activity in Mosai products and client EMRs is logged and auditable, and record access is subject to client and Mosai audit at any time.

Preferred Skills and Experience

• BSN preferred; multi-state RN licensure or eligibility for licensure in additional states strongly preferred, with Nurse Licensure Compact participation preferred.
• Current HCS-D (Home Care Coding Specialist – Diagnosis) certification for ICD-10 coding review as a secondary scope; an OASIS credential and HCS-D together preferred, with BCHH-C or COQS considered as equivalents.
• Dedicated OASIS review, QA, or clinical audit experience; prior experience in an outsourced, vendor, or multi-client review environment.
• Hands-on experience with two or more major home health EMR systems strongly preferred, as this role works directly in multiple client systems.
• Experience using clinical software, decision support, or AI-assisted review tools, with a demonstrated ability to learn new platforms quickly.

Physical Demands of Our Work Environment

This position uses a computer and other office equipment as needed to perform duties. The in-office noise level in the work environment is typical of that of an office. Frequent interruptions may be encountered throughout the workday.

The employee is required to either stand or sit, talk and hear frequently required to use repetitive keying or hand motions.

The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Mosai is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, veteran status, and disability, or other legally protected status, If you are unable to submit an application because of a incompatible assistive technology or disability, please contact us at [e-mail]. We will make every effort to respond to your request for disability assistance as soon as possible.

Mosai is an E-verify employer. Your eligibility to work in the United States will be verified through the E-verify system if you apply and are selected for a position.