[Remote] Clinical Consulting Manager

Note: The job is a remote job and is open to candidates in USA. Netsmart is a healthcare software company dedicated to improving care delivery in behavioral health, human services, and post-acute markets. They are seeking a Clinical Consulting Manager to support clinical excellence and quality outcomes in home health and hospice care, providing guidance and operational support to enhance patient care delivery.ResponsibilitiesPerform documentation review on medical records to identify clinical elements for accuracyPerform post-acute home health and or hospice documentation review on medical records to identify clinical elements for accuracyResearch and provide comments and recommendations on complex or newly issues home health and or hospice billing regulationsReview client information systems for complete and accurate clinical documentationResearch and provide comments and recommendations on complex or newly issued billing regulationsConduct weekly calls with the client to present findings and results of the engagementAnalyze trends and provide process improvement recommendations for clinical operational processes to improve quality of care and patient outcomesReview documentation associated with focused medical reviews and write appeals for denied services; provide denial support at the Administrative Law Judge (ALJ) level of appealsParticipate in cross-team clinical consulting workSkillsAssociate's Degree in nursing, social work, physical therapy or another related disciplineActive and unrestricted license in related fieldAt least 5 years of progressive post acute clinical management experience in home health and /or hospiceExperience with case management in home health and/or hospice with progressive involvement in Quality Assurance activitiesIn-depth knowledge of condition of participations and conditions of payment; extensive knowledge of regulatory standardized assessment documents and patient care protocolsProficient in Microsoft Office Suite including Excel, PowerPoint, and WordExcellent written and verbal communication and presentation skills are requiredBachelor of Science in nursing (BSN), social work (MSW), physical therapy or another related disciplineExperience with Medicare contractor audits and appealsBenefitsComfortable with remote work arrangements and virtual collaboration toolsTravel up to 25% as neededPre-employment background check, including a drug screen, which is provided at Netsmart’s sole expenseCompany OverviewNetsmart is an industry-leading healthcare technology organization dedicated to empowering providers to deliver value-based care to individuals and communities. It was founded in 1968, and is headquartered in Overland Park, Kansas, USA, with a workforce of 1001-5000 employees. Its website is https://www.ntst.com/News-And-Events/pr/OrderConnectCert.