PROSPECTIVE PAYMENT SYSTEM SPECIALIST - HOME CARE Nursing Hours: 8am - 4:30pm Days - Full-time Paygrade/Wages/Salary Info: OH 2013-75B - 40286B
Job Summary Responsible for the timely review, preparation, filing, and tracking required for the Center for Medicare and Medicaid Services (CMS) OASIS documents for all Home Care patients receiving Home Care Services. # Job Responsibilities Reviews, using scrubber software and manual methods, the OASIS clinical assessments performed by licensed home care staff at mandated time points. Ensures compliance with state and federal regulatory guidelines, timely submission of data, and appropriate assessment findings for individual patients. Provides ongoing feedback to all staff regarding CMS guidelines and OASIS assessments. Provides periodic and ongoing OASIS training and updates staff when regulations change. Maintains current knowledge and understanding of OASIS assessment and Plan of Care guidelines. Monitors program compliance and publicly reported data per CMS. Responsible for monitoring and moving case weights toward state and national benchmarks. Coordinates and ensures timely completion of required documentation in the OASIS assessment prior to submission for reimbursement. Ensures that care and services provided are captured accurately and that appropriate reimbursement is occurring per Medicare or Medicaid or other episodic payers relying on OASIS data. Ensures that changes of condition are noted and discussed during client conferences. Qualifications Associate#s degree or higher or Diploma in Nursing required upon hire A minimum of 3 years# relevant experience required RN - Licensed as a Registered Nurse. Eligible to practice nursing in the State of Kentucky required upon hire AND COQS - Certified OASIS-D Quality Specialist (COQS) certification required within 12 months of employment in this position Skills and Attributes Requires critical thinking skills and decisive judgment. Works under minimal supervision. Must be able to work in a stressful environment and take appropriate action. Physical Demands Standing: Occasionally Walking: Occasionally Sitting: Frequently Lifting 0-25 lbs: Rarely Lifting 25-75 lbs: Never Lifting over 75 lbs: Never Carrying 0-25 lbs: Rarely Carrying 25-75 lbs: Never Carrying over 75 lbs: Never Pushing/Pulling 0-25 lbs: Rarely Pushing/Pulling 25-75 lbs: Never Pushing/Pulling over 75 lbs: Never Climbing: Rarely Bending/Stooping: Rarely Kneeling: Rarely Crouching/Crawling: Rarely Reaching: Occasionally Talking: Frequently Hearing: Occasionally Repetitive Foot/Leg Movements: Never Repetitive Hand/Arm Movements: Frequently Keyboard Data Entry: Frequently Running: Never Vision: Depth Perception: Frequently Vision: Distinguish Color: Frequently Vision: Seeing Far: Frequently Vision: Seeing Near: Frequently Owensboro Health Core Commitments INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers. RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community. TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future. INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health. SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do. EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.