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SS
Mgr-RN Quality Review and Coding, Continuum of Care
SSM HealthIL-REMOTE, United States, United StatesRemotefull_timeVerifiedPosted 2 Jun 2026
💰 $132,579/yr($82,867/yr – $132,579/yr)
About the role
It's more than a career, it's a calling
IL-REMOTEWorker Type:
Job Highlights:
We are looking for nurse who possesses leadership and oversight of documentation quality processes for home health and hospice services. This role ensures consistent, high-quality clinical documentation and works collaboratively across teams to maintain compliance and support billing integrity.
In this role you will be responsible for
- Oversee quality review of clinical documentation processes across home health and hospice
- Monitor front-end documentation workflows to ensure consistency, accuracy, and adherence to standards
- Lead and manage the coding team responsible for evaluating documentation for coding accuracy and billing integrity
- Partner with cross-functional stakeholders to identify risks and recommend process improvements impacting documentation and billing
- Support compliance initiatives and uphold organizational standards for documentation quality and integrity
Qualifications
- Experience in clinical documentation quality review, coding, or related healthcare operations
- Strong understanding of documentation standards, coding practices, and billing integrity
- Demonstrated ability to lead teams and manage performance in a complex healthcare environment
- Experience collaborating across departments to drive process improvement and risk mitigation
- Knowledge of home health and/or hospice operations
Pay Range:
$82,867.20 - $132,579.20Pay Rate Type:
SalarySSM Health values the skills and talents that each team member brings to our organization. Compensation for this role is based on a variety of components including relevant experience, labor market, and other qualifications. The posted pay range for this position is what SSM Health reasonably expects, in good faith, to offer based on the circumstances at the time of posting. SSM Health may ultimately pay more or less than the posted range as permitted by law.Job Summary:
Provides oversight and leadership of the daily operations of the quality review and coding team.Job Responsibilities and Requirements:
PRIMARY RESPONSIBILITIES
- Identifies areas for process improvement and participates in the development, implementation, evaluation and monitoring of new processes for quality review and coding. Leads others during implementation of changes.
- Coordinates and communicates key issues, status, or other information with regional operational and system leaders.
- Collaborates with providers to promote quality outcomes for operations. Supports operations by problem identification and resolution, cost containment, implementation of new services, and systems/performance measures. Uses evidence-based research and best practice for improvement of patient care outcomes and clinician efficiency.
- Supports the review of Outcome and Assessment Information Set (OASIS) assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy. Utilizes OASIS variation or alert report when reviewing OASIS data and ensures applicable OASIS files are uploaded and shared to Center for Medicare and Medicaid Services (CMS) portal.
- Notifies organizational leadership of opportunities resulting from the OASIS reviews.
- Serves as subject matter expert for evaluation, management, procedural quality review and coding in assigned areas. Interacts with quality reviewers, coders, physicians, and other health care practitioners to ensure common understanding of coding and documentation, guidelines/principles, government and commercial payer rules and regulations.
- Acts as a resource to physicians, information technology, and quality review and coding teams regarding electronic health record templates and tools. Assists with template development and ongoing review to ensure templates facilitate streamlined workflow for physicians while also ensuring accurate code selection. Provides support to physicians as requested or deemed necessary, may be required to travel to provider.
- Provides oversight to ensure coders can abstract code and work charge/claim review, queues, and coding-rel
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