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Director of Patient Outcomes is responsible for directing the completion of the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS). Provides clinical support in completion of data contained in prospective payment system (PPS) and functional outcome measure (FOM) instruments for each patient to ensure accuracy in the scoring of functional status and reflection of the patient's care needs.
Job Duties include, but are not limited to:- Lead and direct the case management department as assigned, to include: management of staffing needs, and caseloads; education, direction, and mentorship of the Case Management Team, and reporting and assistance in the management of patient outcomes.
- Reports and assists in management of patient outcomes. To include; attending Utilization Reviews and reports as necessary (including managing medical necessity denials), collecting data and monitors Quality Indicators and the Care Tools, maintains FOM credentialing and staff education as well as FOM functions, ensuring accuracy (rounds, education, certification, etc.), reviewing physician documentation for medical necessity and function changes and tracks Compliancy (CMS13) and assists in attainment of required documentation from clinical liaison's and physicians to support.
- Attends Operations/Admissions meetings and reviews patients for tiers and compliance. As well as attending team conferences and assisting Health Information Management (HIM) with accuracy of coded tiers with queries.
Requirements for consideration:- Clinical licensure required (PT, OT, SLP or RN preferred). Other licensure/certification to be considered based on appropriate qualifications.
- Two years of recent experience in acute care setting preferred
- Must maintain acceptable driving record, current driver's license and insurability
We value our employee's skills, talents and input. We believe in maintaining hospital environments where employees are valued, treated with dignity, respected, provided educational and training opportunities recognized and rewarded. These values are included in our competitive and comprehensive compensation and benefits.
