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About the role
Key responsibilities & impact- Lead the team performing OASIS assessment review and ICD-10 coding review for home health clients
- Provide direct people leadership for employed OASIS Reviewers and ICD-10 Coders
- Own the quality standard for employee and contracted review work
- Serve as a client-facing escalation point for disputed findings and represent review methodology to client leadership
- Define and audit the human-in-the-loop standard for AI-assisted review
- Recruit, interview, hire, onboard, and supervise OASIS Reviewers and ICD-10 Coders
- Conduct one-on-ones, performance reviews, improvement plans, and coaching
- Define review accuracy standards, audit methodology, and sampling approaches
- Run recurring quality audits, calibration exercises, and inter-reviewer reliability programs
- Maintain review playbooks and client-specific parameter documentation
- Monitor platform override rates and provide clinical feedback and sign-off to product and engineering
- Forecast review volume, allocate work, match assignments to credentials, and escalate capacity shortfalls
- Explain clinical rationale and CMS guidance in client business reviews and onboarding
- Maintain the credentialed consultant pool and audit contractor deliverables
- Coordinate with legal, compliance, and finance on contractor agreements
- Oversee client EMR access provisioning and deprovisioning, access audits, security training, and privacy incident escalation
- Maintain expertise in OASIS guidance, PDGM, CMS Conditions of Participation, HH QRP, HHVBP, and ICD-10-CM coding
- Incorporate guidance and code-set changes into team standards, training, and platform logic
Requirements
What you’ll need- Active, unrestricted Registered Nurse (RN) license required
- Current COS-C (Certificate for OASIS Specialist – Clinical) or HCS-O (Home Care Clinical Specialist – OASIS) certification required at hire
- Minimum of 5 years of clinical experience in Medicare-certified home health required
- Minimum of 2 years of people leadership experience required, including hiring, performance management, and direct supervision of clinical staff
- Demonstrated experience in OASIS review, clinical QA, coding audit, or documentation integrity required
- Hands-on experience with one or more major home health EMR platforms required
- Deep command of OASIS conventions, item intent, and time point requirements
- Ability to lead a remote, distributed team across multiple clients, EMRs, and time zones
- BSN preferred; Associate’s degree in Nursing with equivalent leadership experience considered
- Multi-state licensure or Nurse Licensure Compact participation preferred
- Current HCS-D certification strongly preferred; BCHH-C or COQS considered as equivalents
- Experience designing or running a clinical quality audit or calibration program strongly preferred
- Prior experience in an outsourced, vendor, or multi-client service environment strongly preferred
- Experience managing or coordinating contract or contingent clinical staff preferred
- Experience with Homecare Homebase preferred
- Experience with clinical software, decision support, or AI-assisted review tools preferred
- Eligibility to work in the United States will be verified through E-Verify
Benefits
Comp & perks- Hybrid work arrangement
- Remote work option with secure, private workspace and reliable internet connection
- Occasional travel for client meetings, team meetings, or industry conferences
- Equal opportunity employment
- Disability accommodations available
