Home Health RN Clinical Compliance Specialist

Adara Home Health, Inc.•Buffalo, MN

3d•$60,000 - $77,000

About The Position

The Clinical Compliance Specialist is responsible for reviewing the client clinical record and verifying that the Home Health Federal Conditions of Participation requirements for home health certification have been met. Ensures clinical information is appropriately documented and in compliance with Federal and State requirements and company policies and procedures. Consults and educates employees to promote clear and concise clinical documentation. The position reports to the Clinical Quality Manager.

Requirements

Currently licensed as a Registered Nurse (RN) or Licensed Practical Nurse (LPN) in the State of Minnesota; home health experience preferred. The license must not have been revoked, suspended and without limitations or restrictions.
Proof of negative TB testing: mantoux skin test, single TB blood test or chest x-ray.
Have U.S. Citizenship or evidence of valid Alien Work Permit.
Disclose any conviction and criminal history records pertaining to any crime related to the provision of health services. A candidate who has been convicted of such crimes will not be hired.
Pass initial and ongoing background studies and screenings including but not limited to those of the Minnesota Department of Health and the Federal Office of the Inspector General’s List of Excluded Individuals and Entities.
Have a minimum of (1) year experience in home health care.
OASIS experience required and COS-C certification preferred.
Demonstrates problem-solving skills, the ability to follow standards/procedures, and make appropriate judgments to support regulatory and company requirements..
Ability to work independently with minimal supervision, adapt to change, and manage a variety of assignments while establishing priorities and ensuring the necessary duties are completed.
Ability to build and maintain professional relationships.
Excellent written and oral communication skills; interpersonal communication and teaching skills.
Basic computer skills and willing to learn new software programs; experience with Electronic Medical Records and Microsoft Outlook preferred.

Responsibilities

Reflects the company’s mission and values in developing and maintaining professional working relationship with others.
Reviews client clinical records and verifies documentation is appropriate for home health certification requirements as defined by the Home Health Conditions of Participation.
Reviews, validates, and optimizes OASIS assessments to ensure accuracy, regulatory compliance, and appropriate reflection of the client’s clinical status.
Supports accurate reimbursement, ensures publicly reported outcomes are accurate, and reduces audit risk by ensuring alignment between clinical documentation, order accuracy, and OASIS data.
Ensures client clinical records are compliant with established professional standards of practice, state and federal regulations, physician/allowed non-physician practitioner orders, payer guidelines and company policies, procedures, and processes.
Serves as a resource to employees by assisting with education and training related to the quality and accuracy of clinical documentation.
Collaborates with employees and other members of the health care team to assist with coordination of client health information and services.
May fulfill the role or job functions of a Clinical Quality Specialist temporarily as needed.
Maintains knowledge and education to remain current, efficient and productive as a resource for home health care certification compliance.
Manages work assignments effectively and remains flexible with unexpected changes.
Performs other related duties and responsibilities as assigned.