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WVUHS Home Care, LLC RN Case Manager: Coder in Clarksburg, West Virginia

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Responsible for coordinating Home Health intake, coding, and/or quality review activities to ensure standards for care are met and patient care is rendered via collaboration with staff, physicians, ancillary services, patients, and family.

MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Current unencumbered licensure with the WV Board of Registered Professional Nurses, or appropriate state board where services will be provided, as a registered professional nurse OR current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). 2. Valid driver's license. 3. CPR certification within 30 days of hire date. 4. Home Health coaching certification upon hire or within three months of hire.

PREFERREDQUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Bachelor's degree in nursing. EXPERIENCE: 1.Two (2) years of Home Health experience. 2. Two (2) years of experience in utilization review/chart audit.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

  1. Responsible for the coordination of intake activities in support of Home Health function. Case Managers assigned to support intake activities responsibilities include but are not limited to:
  • Obtain and process all referral information, assuring accuracy and completeness.
  • Complete intake function correctly at least 95% of the time.
  • Obtain authorization as necessary.
  • Visit patient prior to discharge at least 95% of the time.
  • Describe home health services as needed.
  • Provide contact information for home health services prior to discharge.
  • Manage face-to-face documentation completion.
  • Provide timely communication a patient referrals.
  • Provide end of month referral reports.
  • Accountable for smooth transition from facility to home.
  • Maintain strong hand off communication 100% of the time.
  1. Responsible for the coordination of coding activities in support of Home Health function. Case Managers assigned to support coding activities responsibilities include but are not limited to:
  • Ensure the proper coding principles are utilized per certification.
  • Maintain coding timeline at or below seven days.
  • Ensure that all comorbidities are added to 95% of the time.
  • Ensure coding is completed by third working day of next month 100% of the time.
  • Responsible for completing coding work queues daily.
  • Ensure coding completed correctly and timely.
  • Maintain ongoing communication to keep management aware of funding specific questions or concerns including staff feedback and key trends.
  1. Responsible for the coordination of quality activities in support of Home Health function. Case Managers assigned to support quality activities responsibilities include but are not limited to:
  • Work with leadership to identify quality focus priorities.
  • Ensure that quality audits care completed timely 100% of the time.
  • Identify, define, and develop reports for leadership on a monthly basis.
  • Maintains a detailed up-to-date dashboard showing red/green performance areas.
  • Maintain strong communication patterns to leadership, including twice monthly quality review sessions.
  • Meet with Home Health staff as needed.
  • Responsible for periodic and annual focused quality improvement projects that are detailed, comprehensive and outlines both... For full info follow application link.
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