UTILIZATION REVIEW COORDINATOR RN | UM HEALTH-SPARROW HOME CARE

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UTILIZATION REVIEW COORDINATOR RN | UM HEALTH-SPARROW HOME CARE

9/2/26Sparrow Home Care

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Job ID: 55426

N/A

Description:

Positions Location: Lansing, MI

Job Description

General Purpose of Job:

Assess and provide guidance and review to clinical staff regarding clinical documentation for accuracy as it relates to Coding, OASIS, and plan of care development according to regulatory guidelines.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Caregivers may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Participation, JCAHO standards, OASIS, and monitoring utilization of services for improving patient outcomes and agency profitability.
• Reviews plan of care and re-certification for medical necessity, clinical appropriateness, and completeness. Interprets data gathered to make recommendations for change as needed to support compliance issues.
• Conduct ICD-10 coding to ensure all regulatory guidelines are met
• Communicates with physicians, nurses, and other disciplines to establish a coordinate home care plan.
• Supports the performance improvement process through data collections as requested, by conducting chart audits and assisting in a variety of reports, using critical thinking skills.
• Conduct audits to include OASIS for accuracy, Plan of treatment review, and appropriate physician order review
• Communicates OASIS and Plan of Care edits to the appropriate caregiver in a timely manner to ensure timely completion of the OASIS to maintain regulatory compliance.
• Provide education and act as a resource to caregivers in the areas of coding, care plan development and OASIS accuracy.
• Other duties as assigned

Job Requirements

General Requirements • Valid State of Michigan Nursing License • Active American Heart Association (AHA) BLS Certification upon hire Work Experience • Minimum of two (2) years previous hospital/home care experience • Must have experience in OASIS quality review in Home Care environment • Experience in ICD-10 coding in Home Care environment. preferred. Education • Minimum of an Associate Degree in Nursing Specialized Knowledge and Skills Required: • Ability to implement and follow policies and procedures in Agency and Health System. • Ability to assure confidentiality regarding sensitive materials. • Demonstrated excellent interpersonal/communication skills, verbal and written. • Demonstrates ability to use a keyboard as may be required to perform the essential duties of the job Preferred: • Bachelors Degree in Nursing • Previous direct patient care in a home care agency • Utilization review

University of Michigan Health-Sparrow is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

Job Family

Registered Nurses/Nursing Leadership

Requirements:

Shift

• Days

Days Degree Type / Education Level

• Associate

Associate Status

• Full-time

Full-time Facility

• Sparrow Home Care

Sparrow Home Care Experience Level

• Under 4 Years

Under 4 Years

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