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About the role
Key responsibilities & impact- Perform clinical review and validation of OASIS assessments for contracted home health agency clients
- Use Mosai’s AI-assisted review platform and client electronic medical records to independently verify platform-generated findings
- Review OASIS assessments at Start of Care, Resumption of Care, Recertification, Transfer, and Discharge
- Validate OASIS responses against the current OASIS data set, CMS Guidance Manual, skip logic, and CMS Quarterly OASIS Q&As
- Verify internal consistency between OASIS responses and supporting records, especially Section GG, cognitive and behavioral items, and case-mix-impacting M-items
- Apply PDGM requirements, including clinical grouping, functional impairment level, comorbidity adjustment, and LUPA exposure
- Review ICD-10-CM diagnosis assignment and sequencing where credentialed, as a secondary scope
- Escalate coding or OASIS conflicts to Mosai clinical operations
- Produce written, compliant, non-leading recommendations with supporting documentation, applicable guidance, and clinical rationale
- Enter recommendations through client-defined channels, meet turnaround commitments, and track recommendations to closure
- Work across multiple client agencies and EMR platforms
- Access protected health information according to HIPAA minimum necessary requirements and applicable Business Associate Agreements
- Maintain review accuracy at or above Mosai clinical quality standards
- Participate in calibration exercises
- Report platform false positives, missed findings, and outdated guidance references
- Perform production review work that is not client-facing; route questions and escalations through clinical operations and client services
Requirements
What you’ll need- 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 at time of hire
- Minimum of 3 years of clinical experience in Medicare-certified home health, including hands-on completion or review of OASIS assessments
- Hands-on experience with at least one major home health EMR, such as Homecare Homebase, WellSky, Axxess, or KanTime
- 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 unsupported by the record
- Strong written communication, high attention to detail, and ability to work independently in a remote environment while meeting daily throughput targets
- BSN preferred
- Multi-state RN licensure or eligibility for additional-state licensure strongly preferred; Nurse Licensure Compact participation preferred
- Current HCS-D certification preferred for ICD-10 coding review; BCHH-C or COQS considered as equivalents
- Dedicated OASIS review, QA, or clinical audit experience preferred
- Experience in an outsourced, vendor, or multi-client review environment preferred
- Hands-on experience with two or more major home health EMR systems strongly preferred
- Experience using clinical software, decision support, or AI-assisted review tools preferred
- Eligibility to work in the United States is verified through E-Verify
Benefits
Comp & perks- Hybrid work arrangement based in Nashville or Jacksonville
- Remote work option with a secure, private workspace and reliable internet connection
- Occasional travel for training or team meetings; no client site visits required
- Equal opportunity employment
- Reasonable accommodations for individuals with disabilities