Utilization Workflow Manager

Job not on LinkedIn

🔥 13 hours ago

🇺🇸 United States – Remote

💵 $70k - $90k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Graham Healthcare Group

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2003

🏥 Healthcare

⚕️ Healthcare Insurance

🏢 Enterprise

Healthcare • Healthcare Insurance • Enterprise

Graham Healthcare Group is a company focused on delivering high-quality post-acute care services by partnering with health systems to provide care in patient homes and communities. They address the fiscal challenges faced by healthcare providers through innovative home-based care models and collaborative partnerships. With a commitment to improving population health, clinical performance, and patient experiences, Graham Healthcare Group uses a buy-and-hold strategy with permanent capital to ensure long-term partnerships. They serve over 80,000 patients annually, working closely with hospitals, health systems, and physician groups to enhance post-acute service lines and drive efficiency. Their main goal is to offer integrated care solutions that improve operational, financial, and clinical outcomes while reducing healthcare costs.

📋 Description

• Analyze patient data and consistency of OASIS documentation, orders, and visit assessments • Review coding, OASIS accuracy, completion, compliance, accreditation, and utilization standards • Review clinician OASIS documentation and plans of care • Approve plans of care for provider signature after verifying content, accuracy, orders, treatments, goals, and visit frequency • Recommend corrections for plan-of-care and OASIS inconsistencies, omissions, and discrepancies • Monitor OASIS locking for each event and complete workflows within the desired timeframe • Evaluate visit frequency and service utilization in collaboration with assessing clinicians • Use HCHB tools and reports to recommend appropriate discipline-specific utilization • Use SHP and other company-provided analyzer tools and address documentation-improvement alerts • Collaborate with coding partners to complete OASIS workflows • Obtain additional provider or facility records to improve plan-of-care and OASIS accuracy • Escalate documentation-improvement opportunities to supervisors and leadership

🎯 Requirements

• Minimum of two years’ experience in home health with experience in quality, supervisor, or staff development roles • Licensed RN or PT in good standing from an accredited program required • Must have and maintain a professional license, certificate, or registration in good standing • OASIS and coding experience strongly preferred • HCHB experience preferred • ICD Coding/OASIS certification preferred • Strong organization skills and attention to detail • Effective verbal and written communication skills with leadership abilities • Ability to work autonomously • Ability to work in front of a computer for long periods to review documentation and workflow • Successful completion of a pre-employment drug screen • Legally authorized to work in the United States

🏖️ Benefits

• Medical benefits: health, vision, and dental insurance • 401(k) and pension with 4% employer contribution • 15 days PTO • Company-paid life insurance • Company-paid disability benefits • Pre-tax FSA and HSA plans • 50% tuition discounts for selected Purdue and Kaplan courses • Opportunity for advancement • Fully remote work arrangement