[Hiring] Clinical Reviewer @Adventist HealthCare

Role Description

Adventist HealthCare seeks to hire a Clinical Reviewer (RN/PT/OT) who will embrace our mission to extend God’s care through the ministry of physical, mental and spiritual healing.

• Directs clinical staff through oversight and management of coding, care plan effectiveness and care provision to patients.
• Obtains verbal orders for additional services or delays in services when needed.
• Examines documentation to ensure clinical information is complete and accurate.
• Complete initial medical record reviews within 24 hours of SOC Assessment for accurate OASIS submission by using Strategic Healthcare Programs (SHP) to assess and monitor OASIS accuracy.
• Develop and implement education initiatives to improve documentation for quality reporting based on trends identified during record reviews.
• Remains current with ICD-10 Coding changes, OASIS guidelines, CMS changes and other agency directives.
• Provide support to ensure that clinical information and quality data utilized in profiling and reporting is complete and accurate.
• Identifies issues requiring clarification or additional information in the clinical documentation and initiates communication with the appropriate care provider using the established processes.
• Orients new clinical staff by providing education and feedback to team members related to documentation content, timeliness of completion, and critical thinking skills as identified. Shares information with clinical leadership as appropriate.
• Participates in weekly interdisciplinary case conferences and problem case conferences with team members, as requested.

Qualifications

• Bachelor’s degree in physical therapy, Occupational Therapy or related area required.
• Associates Degree in Nursing Required.
• Two years of clinical experience.
• Experience in the Home Health environment setting preferred.
• Experience in conducting research trials preferred.
• OASIS certification, recommended.
• Coding certification, recommended.
• Current license (RN/PT/OT).

Requirements

• Must already be certified in OASIS and coding with prior experience.
• Employment Type: Variable Part-Time.
• Typical Daily Schedule: As needed for PTO coverage.
• Shift Type: Day.
• Weekend Requirements: Occasional.
• Holiday Requirements: Occasional.
• On-Call: Occasional.
• Shift Differential Eligible: No.

Benefits

• Work life balance through nonrotating shifts.
• Recognition and rewards for professional expertise.
• 403(b) retirement plan.
• Free Employee parking.
• Employee Assistance Program (EAP) support.