Overview
On Site
Depends on Experience
Contract - W2
Job Details
RN Home Health Reviewer | Irving, TX | Contract
Walker Healthforce is seeking a RN Home Health Reviewer for a healthcare client located in Irving, TX. This is a contract opportunity.
START DATE: ASAP
Walker Healthforce Standard Perks:
Summary:
The RN Navigator Home Health Review monitors home health patients to ensure patients continue to meet the CMS criteria for services. They are a member of the patient’s care team and act as a patient advocate, providing proactive outreach to value-based payer patients. The RN Navigator makes recommendations to primary care providers regarding ongoing services. The RN Navigator facilitates communication and coordinates care with physicians, the providers’ clinic, hospital facilities, family, caregivers, and other community healthcare providers. The Associate will support transitions of care as needed.
Responsibilities:
Requirements:
2 years of Home health experience preferred.
2-3 years of managed care and/or care management experience preferred.
Experience: 3-5 years of clinical experience required.
PREFERRED JOB REQUIREMENTS:
Bachelor’s Degree in Nursing preferred.
RN license in the state of employment or compact is required.
Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
#IND1
Walker Healthforce is seeking a RN Home Health Reviewer for a healthcare client located in Irving, TX. This is a contract opportunity.
START DATE: ASAP
Walker Healthforce Standard Perks:
- Weekly pay via Direct Deposit
- Medical, Dental, and Vision Available
- 401K
Summary:
The RN Navigator Home Health Review monitors home health patients to ensure patients continue to meet the CMS criteria for services. They are a member of the patient’s care team and act as a patient advocate, providing proactive outreach to value-based payer patients. The RN Navigator makes recommendations to primary care providers regarding ongoing services. The RN Navigator facilitates communication and coordinates care with physicians, the providers’ clinic, hospital facilities, family, caregivers, and other community healthcare providers. The Associate will support transitions of care as needed.
Responsibilities:
- Leader of Self, Leader of Others, or Leader of Leaders. Stays abreast of current CMS and other payer guidelines for Home Health services.
- Receives and evaluates Home Health 485 form (Plan of Care) based on Medical Necessity guidelines and Homebound Status requirements. Facilitates Case Conferences with Home Health Agencies for evaluation of patient progress toward goals and discharge plan.
- Ensures Home Health agency is addressing the problem list and providing appropriate follow up for patient needs. Based on CMS or other payer guidelines, patient assessment, and case conferences, makes recommendation to PCP regarding Home Health recertification or discharge from service.
- Utilizes MCG Guidelines for Home Care to optimize the type, frequency, and duration of care. Creates positive relationships with Home Health agencies as well as Primary Care Clinicians and Office Staff.
- Ensures smooth transition of care along the continuum. Facilitates communication between Home Health agencies and PCP practices as necessary to ensure patient's needs are addressed.
- Demonstrates expertise in navigating electronic medical record and other care management applications.
- Monitors key measures of program success and provides feedback regarding opportunities to improve. Collaborates with team members in the discharge process, performing outreach/documentation according to CMS guidelines and the Population Health workflow.
- Outreach to TOC patients should focus on medication reconciliation/adherence, self-management, use of personal health records, follow-up with PCPs/Specialists, and review of indicators that a patient’s condition is worsening and how to respond.
- Promotes a positive work environment by displaying a caring, sensitive approach to others, as evidenced by listening, understanding, and responding to the needs of patients, colleagues, and supervisors. Performs other duties as assigned.
Requirements:
2 years of Home health experience preferred.
2-3 years of managed care and/or care management experience preferred.
Experience: 3-5 years of clinical experience required.
PREFERRED JOB REQUIREMENTS:
Bachelor’s Degree in Nursing preferred.
RN license in the state of employment or compact is required.
Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
#IND1
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