Director of Patient Outcomes

ClearSky Health•Cleveland, WI

About The Position

The Director of Patient Outcomes directs completion of the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) and provides clinical support for completing prospective payment system (PPS) and functional outcome measure (FOM) instruments for each patient. The role ensures accurate functional-status scoring and that documentation reflects patients’ care needs. The position may also direct the Case Management Department as needed and is expected to integrate company values into daily practice.

Requirements

Clinical licensure is required; PT, OT, SLP, or RN is preferred. Other licensure or certification may be considered based on appropriate qualifications.
Must maintain an acceptable driving record, a current driver’s license, and insurability.

Nice To Haves

Two years of recent experience in an acute care setting preferred.
PT, OT, SLP, or RN licensure preferred.

Responsibilities

Lead and direct the Case Management Department when assigned, including staffing needs, caseloads, and education, direction, and mentorship of the Case Management Team.
Report on and assist with management of patient outcomes.
Attend Utilization Reviews and provide reports as needed, including managing medical necessity denials.
Collect data and monitor Quality Indicators and Care Tools.
Maintain FOM credentialing, staff education, and FOM functions, ensuring accuracy through rounds, education, and certification.
Review physician documentation for medical necessity and changes in function.
Track Compliancy (CMS13) and help obtain required supporting documentation from clinical liaisons and physicians.
Attend Operations and Admissions meetings and review patients for tiers and compliance.
Attend team conferences and assist Health Information Management (HIM) with the accuracy of coded tiers through queries.