Job description
Clinical Consulting Supervisor – Hospice Chart Review - Remote
Reporting to the Senior Manager, the Clinical Consulting Supervisor provides clinical expertise with hospice client engagements and working McBee Associates operations experts. The focus of this position will be for remote supplemental support. The clinical consulting supervisor will assist in hospice clinical chart reviews for accuracy and completeness of records, assist with denials and appeals, and provide insight for client improvements. The scope of work may also include home health reviews and on-site client assessments.
Reporting to the Senior Manager, the Clinical Consulting Supervisor provides clinical expertise with hospice client engagements and working McBee Associates operations experts. The focus of this position will be for remote supplemental support. The clinical consulting supervisor will assist in hospice clinical chart reviews for accuracy and completeness of records, assist with denials and appeals, and provide insight for client improvements. The scope of work may also include home health reviews and on-site client assessments.
Responsibilities
- Perform remote reviews of client medical records as instructed by scope of work
- Research and provide comments and recommendations on hospice or home health billing regulations
- Perform documentation review on medical records to identify clinical elements for hospice or home health service lines for accuracy.
- Conduct weekly calls with the client to review findings from a review completed.
- Analyze trends and provide recommendations for hospice or home health operational processes to improve quality of care and patient outcomes
- Recommend hospice or home health improvements based on clinical documentation and interaction with the client
- Review client information systems for clinical documentation
- Review Hospice and Home Health documentation, denials, and write appeals for denied home health and hospice services
Qualifications
Required
- Associate’s Degree in nursing (ADN), social work, or another related discipline.
- Active license in related field
- At least 5 years of progressive home health and/or hospice clinical management experience.
- At least 3 years experience in quality assurance and/or case management.
- Excellent written and oral communication and presentation skills are required.
- Knowledge of Excel and Word basic functionality.
- Ability to effectively communicate by correspondence, telephone, and personal interaction.
- Ability to negotiate effectively, analyze and perform routine and complex problem resolution.
Expectations
- Ability to connect to Hi Speed internet
- Knowledge of basic computer function and internet processes
- This job operates in a home office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing systems and fax machines.
- Must be able to work extended hours beyond 8 a.m. to 5 p.m. Monday-Friday, including some weekends.
- Must be able to remain in a stationary position 50% of the time and constantly operate a computer.
- Ability to communicate with internal, external and executive personnel and must be able to listen and exchange accurate information.
- Ability to periodically travel to client sites throughout the country including overnight travel is required.
Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.
Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart’s sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart’s third party screening provider. Additionally, a positive result for marijuana will not automatically disqualify a candidate from employment if the individual can provide a valid prescription for medicinal use issued in his or her state of residence. A prescription is required even in states where recreational use has been legalized.
All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.
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