Demo

Manager- Home Health Coding and Quality Review

Yale New Haven Health
Guilford, CT Full Time
POSTED ON 1/20/2025
AVAILABLE BEFORE 3/20/2025
Overview:
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

Reporting to the Manager of Quality Operations, the Manager for Home Care Coding & Quality Review (QR) is responsible for the day-to-day operations and management of the coding and OASIS/QR reviews for Home Care & Hospice, including direct oversight of the staff who perform these functions from a quality, clinical documentation, regulatory, and accuracy perspective.

EEO/AA/Disability/Veteran
Responsibilities:
  • 1. Home Care & Hospice Coding & OASIS/QR
    • 1.1 Manages the day-to-day operations of home health coding and OASIS/QR reviews and OASIS submission
  • 2. Home Care Mergers/Acquisitions and EMR integration
    • 2.1 Functional coding and QR operational lead for home care/hospice mergers and acquisitions
  • 3. Performance Management/Quality Management
    • 3.1 Recruits and manages the performance of a collaborative team of highly skilled coding and nursing professionals with clinical, coding, reimbursement, and regulatory expertise
  • 4. Vendor management/support
    • 4.1 Vendor management and oversight for coding/QR as indicated
  • 5. Performs other responsibilities as needed by senior leadership to support the department and organization
Qualifications:
EDUCATION

Bachelors degree in nursing (BSN) or health-related field required.

EXPERIENCE

Minimum of 1 year of clinical home health experience required. Coding and/or Quality Review supervisory or managerial experience preferred.

LICENSURE

OASIS (HCS-O, COS-C, or COQS) and/or Home Care Coding (HCS-D or BCHH-C) certification required, or must be obtained within nine (9) months of hire. Registered Nurse (RN) licensure required.

SPECIAL SKILLS

Current knowledge of PDGM coding and outcomes. Knowledge of federal regulations and state licensure requirements. Experience and proficiency in communication skills and building relationships across home care agencies. Proficient in the use of electronic documentation and home care EMRs and system integrations. Knowledgeable of mid-revenue cycle. Background in management, operations, or quality assurance within home health agencies.

Additional Information:
  • RN Manager; Current knowledge of PDGM coding and outcomes.
  • Knowledge of federal regulations and state licensure requirements.
  • Experience and proficiency in communication skills and building relationships across home care agencies.
  • Proficient in the use of electronic documentation and home care EMRs and system integrations.
  • Knowledgeable of mid-revenue cycle.
  • Background in management, operations, or quality assurance within home health agencies.

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