Oasis Reviewer - Home Health

Mosai•Nashville, TN

9d•Hybrid

About The Position

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. This 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.

Requirements

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.

Nice To Haves

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.

Responsibilities

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.