Join Compassus as a Utilization Review Registered Nurse and Make a Difference in Home Health Care
At Compassus, we're dedicated to providing compassionate care to individuals and families in need. As a leading provider of hospice and home health services, we're committed to upholding the highest standards of quality, integrity, and excellence. We're seeking an experienced Utilization Review Registered Nurse to join our team in Brentwood, TN, and work remotely to drive positive outcomes in home health care.
About the Role
As a Utilization Review Registered Nurse, you'll play a critical role in ensuring the quality and appropriateness of patient care provided by our home health agency. You'll work closely with interdisciplinary teams, healthcare providers, and insurance agencies to review and evaluate medical records, treatment plans, and patient progress. Your expertise will help us optimize patient outcomes, improve operational efficiency, and maintain regulatory compliance.
Key Responsibilities
- Conduct comprehensive reviews of patient medical records and treatment plans to assess the appropriateness and necessity of home health services.
- Identify discrepancies or opportunities for improvement in patient care and collaborate with healthcare professionals to gather necessary information.
- Ensure adherence to home health regulations, guidelines, and standards set by relevant governing bodies, insurance companies, and accrediting agencies.
- Participate in quality improvement initiatives, suggesting strategies to enhance patient outcomes and operational efficiency.
- Generate reports, analyze data, and identify trends to improve the utilization review process.
- Maintain accurate and complete records of utilization review activities, decisions, and communications.
- Collaborate with billing and coding teams to ensure proper documentation of services and support accurate and timely reimbursement.
- Provide guidance and education to home health staff on utilization review processes, documentation requirements, and compliance standards.
- Support complex patient care needs by collaborating with Case Managers and providing education on effective care planning strategies.
- Stay up-to-date with changes in healthcare regulations, payer policies, and best practices in home health utilization review.
Essential Qualifications
To be successful in this role, you'll need:
- An Associate or Bachelor's degree in Nursing.
- A minimum of three (3) years of experience in healthcare, preferably in a home health setting.
- Home health OASIS knowledge.
- An active and unencumbered license as a Registered Nurse in the state(s) of employment.
Preferred Qualifications
While not required, the following qualifications are strongly preferred:
- Knowledge and experience in visit utilization, managed care payor models, and quality improvement.
- Experience working in a home health setting.
Skills and Competencies
To excel in this role, you'll need:
- Strong mathematical skills, including the ability to add, subtract, multiply, and divide in all units of measure.
- Excellent language skills, including the ability to read, analyze, and interpret complex information and communicate effectively in writing and verbally.
- The ability to understand, read, write, and speak English.
- A strong understanding of hospice philosophy and a commitment to articulating and embracing it.
Career Growth Opportunities and Learning Benefits
At Compassus, we're committed to supporting the growth and development of our team members. As a Utilization Review Registered Nurse, you'll have opportunities to:
- Develop your skills and expertise in home health care and utilization review.
- Collaborate with interdisciplinary teams and healthcare professionals to drive positive outcomes.
- Participate in quality improvement initiatives and contribute to the development of best practices.
Work Environment and Company Culture
At Compassus, we pride ourselves on creating a fair and inclusive work environment where our team members feel welcomed, highly valued, and respected. As an equal opportunity employer, we're committed to diversity, equity, and inclusion. Our team members enjoy:
- A remote work arrangement, allowing for flexibility and work-life balance.
- A collaborative and supportive team environment.
- Ongoing training and development opportunities.
Compensation and Benefits
We offer a competitive salary range of $68,000 - $79,000 per year, along with a comprehensive benefits package. While specific benefits may vary, our total rewards program is designed to support the well-being and financial security of our team members.
Why Join Compassus?
At Compassus, we're passionate about making a difference in the lives of individuals and families. As a Utilization Review Registered Nurse, you'll play a critical role in driving positive outcomes in home health care. If you're a compassionate and experienced professional looking for a challenging and rewarding opportunity, we encourage you to apply.
Don't miss this opportunity to join our team and make a meaningful impact. Apply now!
Apply Now