Manager, Clinical Review Services
Mosai · Nashville, TN · 4 wk ago
HybridFull-time
We need to output HTML fragment with sections: About the role? The posting includes "About Mosai" description, then "Position Summary", then "Job Duties", then "Minimum Requirements", then "Work Environment", then "Preferred Skills And Experience", then "Physical Demands of Our Work Environment". Also there is EEO boilerplate etc which we must remove. Also we must not repeat job title as heading (the page already shows it). No Job ID etc.
We need to use for section headings. Use
for section headings. Use - for any list of duties/requirements/benefits, and
for prose. Include a section only when posting has real specific content. Must preserve all substantive info, not invent or summarize away detail. Remove boilerplate, duplicated lines, application instructions.
We need to decide which sections to include: About the role? There's "About Mosai" description (company overview). Could be considered "About the role"? The instruction says use headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. But we can adapt headings to match content. Probably we should use headings that reflect sections: About Mosai (maybe "About the role"?), Position Summary (maybe "About the role"?), Job Duties (Responsibilities), Minimum Requirements (Requirements/Qualifications), Preferred Skills And Experience (Skills), Work Environment (maybe Schedule? but it's about environment), Physical Demands (maybe not a standard heading but we could include as a section if content present). However instruction: "use
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It suggests we can use those headings, but not required to use exactly those; we can use appropriate headings. Probably better to map: About Mosai -> About the role (or About the company). Position Summary could be part of About the role. But we need to avoid filler. We'll create sections: About the role (combining About Mosai and Position Summary). Responsibilities (Job Duties). Requirements (Minimum Requirements). Skills (Preferred Skills And Experience). Work Environment (Work Environment). Physical Demands (Physical Demands of Our Work Environment). No Pay, Schedule, Benefits sections because not present.
We must not include boilerplate like EEO, E-verify, contact info, etc. Also remove duplicated lines.
We need to preserve all substantive info. Let's extract content.
About Mosai: "Mosai™ is the intelligent care coordination platform that brings together the fragmented pieces of healthcare into a clear, connected picture. Like a mosaic, our platform unites data, people, and processes so providers can make better decisions, coordinate care in real time, and deliver improved outcomes. With Mosai, home-based care organizations can thrive in value-based care while giving every patient the right care, in the right place, at the right time. Learn more at https://www.mosai.com/"
Position Summary: "Leads the team that performs OASIS assessment review and ICD-10 coding review for Mosai’s home health clients, with direct people leadership over employed OASIS Reviewers and ICD-10 Coders and ownership of the quality standard applied to all review work, including work performed by contracted consultants.May be client-facing; serves as the escalation point that resolves disputed findings, represents review methodology to client leadership, and absorbs the client relationship so reviewers can stay focused on production and accuracy.Owns the human-in-the-loop standard for Mosai’s AI-assisted review platform, defining and auditing the expectation that licensed clinicians validate platform findings against the source record, and serves as the clinical counterpart to product and engineering on platform accuracy."
We can combine.
Job Duties list: many bullet-like sentences. We need to turn into - . Let's parse each duty:
- Recruit, interview, hire, and onboard OASIS Reviewers and ICD-10 Coders, verifying licensure and required credentials and supervising ramp on live review work to a defined accuracy threshold before independent assignment.
- Conduct one-on-ones, deliver performance feedback and reviews, manage underperformance through documented improvement plans, and coach reviewers on the quality of written recommendations.
- Define, document, and maintain the review accuracy standard, audit methodology, and sampling approach; run a recurring quality audit program across employees and contractors with findings, trending, and documented corrective action.
- Facilitate calibration and inter-reviewer reliability exercises, investigate and resolve inconsistent findings between reviewers, and maintain the review playbook and client-specific parameter documentation.
- Monitor platform override rates and own the human-in-the-loop policy for AI-assisted review, holding the team accountable to independent validation of every platform finding; serve as clinical point of contact to product and engineering, aggregating feedback and providing clinical sign-off on platform changes.
- Forecast review volume, allocate work across employees and contractors to meet contracted turnaround commitments, match assignments to credentials held, and escalate capacity shortfalls before they affect client billing.
- Serve as the escalation point for disputed findings, explaining clinical rationale and applicable CMS guidance to client clinical leadership, and represent review methodology and quality standards in client business reviews and onboarding.
- Maintain a credentialed consultant pool, match contract assignments to credentials and client scope, audit contractor deliverables against the same accuracy standard applied to employees, and coordinate with legal, compliance, and finance on contractor agreements — without directing a consultant’s hours, schedule, or method of performing review.
- Oversee client EMR access provisioning and deprovisioning, audit access and activity logs, ensure required security, HIPAA, and compliance training is completed before client work begins, and escalate suspected privacy incidents or unauthorized access immediately.
- Maintain current expertise in OASIS guidance, PDGM, CMS Conditions of Participation, HH QRP, HHVBP, and ICD-10-CM coding for home health, and own the process for absorbing guidance and code set changes into team standards, training, and platform logic.
Minimum Requirements list:
- Active, unrestricted Registered Nurse (RN) license required.
- Current COS-C (Certificate for OASIS Specialist – Clinical) or HCS-O (Home Care Clinical Specialist – OASIS) certification required at hire.
- Minimum of 5 years of clinical experience in Medicare-certified home health required.
- Minimum of 2 years of people leadership experience required, including hiring, performance management, and direct supervision of clinical staff.
- Demonstrated experience in OASIS review, clinical QA, coding audit, or documentation integrity required.
- Hands-on experience with one or more major home health EMR platforms required.
- Deep command of OASIS conventions, item intent, and time point requirements sufficient to adjudicate disagreements between experienced reviewers, and the ability to lead a remote, distributed team across multiple clients, EMRs, and time zones.
Work Environment:
- This is a hybrid role based in Jacksonville or Nashville.
- Primarily sedentary work performed in a remote or office setting, with extended periods of computer and screen use.
- May be client-facing; serves as the escalation point for disputed findings and represents review methodology to client leadership.
- Remote work requires a secure, private workspace and a reliable internet connection meeting Mosai and client security standards.
- Occasional travel for client meetings, team meetings, or industry conferences.
- Holds full authority over review standards, staffing, and the quality program, but no authority over client clinical records, submissions, or clinical practice.
Preferred Skills And Experience:
- BSN preferred; Associate’s degree in Nursing with equivalent leadership experience considered.
- Multi-state licensure or Nurse Licensure Compact participation preferred.
- Current HCS-D (Home Care Coding Specialist – Diagnosis) certification strongly preferred, given oversight of coding review work and audit of coding deliverables; BCHH-C or COQS considered as equivalents.
- Experience designing or running a clinical quality audit or calibration program strongly preferred; prior experience in an outsourced, vendor, or multi-client service environment strongly preferred.
- Experience managing or coordinating contract or contingent clinical staff preferred; experience with Homecare Homebase preferred.
- Experience with clinical software, decision support, or AI-assisted review tools preferred.
Physical Demands of Our Work Environment:
- This position uses a computer and other office equipment as needed to perform duties.
- The in-office noise level in the work environment is typical of that of an office.
- Frequent interruptions may be encountered throughout the workday.
- The employee is required to either stand or sit, talk and hear frequently required to use repetitive keying or hand motions.
- The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
We must remove EEO etc. Also remove "Learn more at https://www.mosai.com/" maybe keep as part of About Mosai? It's substantive? It's a link; could keep but it's not essential. Might be considered boilerplate? It's a link to learn more; maybe keep as part of About Mosai. The instruction: remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. The link is not boilerplate; it's a reference. Could keep.
We must not invent or summarize away detail. So we need to keep all details.
Now produce HTML fragment with sections.
We'll use
for each section heading.
Section headings: About the role (maybe combine About Mosai and Position Summary). Responsibilities (Job Duties). Requirements (Minimum Requirements). Skills (Preferred Skills And Experience). Work Environment (Work Environment). Physical Demands (Physical Demands of Our Work Environment).
We'll put content in
for prose, and
- for lists.
For About the role: we have two paragraphs: About Mosai description and Position Summary. Could combine into one
with both sentences? Better to keep as two
elements.
But we need to avoid duplication. We'll output:
About the role
Mosai™ is the intelligent care coordination platform that brings together the fragmented pieces of healthcare into a clear, connected picture. Like a mosaic, our platform unites data, people, and processes so providers can make better decisions, coordinate care in real time, and deliver improved outcomes. With Mosai, home-based care organizations can thrive in value-based care while giving every patient the right care, in the right place, at the right time. Learn more at https://www.mosai.com/
Leads the team that performs OASIS assessment review and ICD-10 coding review for Mosai’s home health clients, with direct people leadership over employed OASIS Reviewers and ICD-10 Coders and ownership of the quality standard applied to all review work, including work performed by contracted consultants. May be client-facing; serves as the escalation point that resolves disputed findings, represents review methodology to client leadership, and absorbs the client relationship so reviewers can stay focused on production and accuracy. Owns the human-in-the-loop standard for Mosai’s AI-assisted review platform, defining and auditing the expectation that licensed clinicians validate platform findings against the source record, and serves as the clinical counterpart to product and engineering on platform accuracy.
Then Responsibilities:
Responsibilities
- Recruit, interview, hire, and onboard OASIS Reviewers and ICD-10 Coders, verifying licensure and required credentials and supervising ramp on live review work to a defined accuracy threshold before independent assignment.
- Conduct one-on-ones, deliver performance feedback and reviews, manage underperformance through documented improvement plans, and coach reviewers on the quality of written recommendations.
- Define, document, and maintain the review accuracy standard, audit methodology, and sampling approach; run a recurring quality audit program across employees and contractors with findings, trending, and documented corrective action.
- Facilitate calibration and inter-reviewer reliability exercises, investigate and resolve inconsistent findings between reviewers, and maintain the review playbook and client-specific parameter documentation.
- Monitor platform override rates and own the human-in-the-loop policy for AI-assisted review, holding the team accountable to independent validation of every platform finding; serve as
for prose. Include a section only when posting has real specific content. Must preserve all substantive info, not invent or summarize away detail. Remove boilerplate, duplicated lines, application instructions. We need to decide which sections to include: About the role? There's "About Mosai" description (company overview). Could be considered "About the role"? The instruction says use headings like About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. But we can adapt headings to match content. Probably we should use headings that reflect sections: About Mosai (maybe "About the role"?), Position Summary (maybe "About the role"?), Job Duties (Responsibilities), Minimum Requirements (Requirements/Qualifications), Preferred Skills And Experience (Skills), Work Environment (maybe Schedule? but it's about environment), Physical Demands (maybe not a standard heading but we could include as a section if content present). However instruction: "use
for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule)." It suggests we can use those headings, but not required to use exactly those; we can use appropriate headings. Probably better to map: About Mosai -> About the role (or About the company). Position Summary could be part of About the role. But we need to avoid filler. We'll create sections: About the role (combining About Mosai and Position Summary). Responsibilities (Job Duties). Requirements (Minimum Requirements). Skills (Preferred Skills And Experience). Work Environment (Work Environment). Physical Demands (Physical Demands of Our Work Environment). No Pay, Schedule, Benefits sections because not present.
We must not include boilerplate like EEO, E-verify, contact info, etc. Also remove duplicated lines.
We need to preserve all substantive info. Let's extract content.
About Mosai: "Mosai™ is the intelligent care coordination platform that brings together the fragmented pieces of healthcare into a clear, connected picture. Like a mosaic, our platform unites data, people, and processes so providers can make better decisions, coordinate care in real time, and deliver improved outcomes. With Mosai, home-based care organizations can thrive in value-based care while giving every patient the right care, in the right place, at the right time. Learn more at https://www.mosai.com/"
Position Summary: "Leads the team that performs OASIS assessment review and ICD-10 coding review for Mosai’s home health clients, with direct people leadership over employed OASIS Reviewers and ICD-10 Coders and ownership of the quality standard applied to all review work, including work performed by contracted consultants.May be client-facing; serves as the escalation point that resolves disputed findings, represents review methodology to client leadership, and absorbs the client relationship so reviewers can stay focused on production and accuracy.Owns the human-in-the-loop standard for Mosai’s AI-assisted review platform, defining and auditing the expectation that licensed clinicians validate platform findings against the source record, and serves as the clinical counterpart to product and engineering on platform accuracy."
We can combine.
Job Duties list: many bullet-like sentences. We need to turn into - . Let's parse each duty:
- Recruit, interview, hire, and onboard OASIS Reviewers and ICD-10 Coders, verifying licensure and required credentials and supervising ramp on live review work to a defined accuracy threshold before independent assignment.
- Conduct one-on-ones, deliver performance feedback and reviews, manage underperformance through documented improvement plans, and coach reviewers on the quality of written recommendations.
- Define, document, and maintain the review accuracy standard, audit methodology, and sampling approach; run a recurring quality audit program across employees and contractors with findings, trending, and documented corrective action.
- Facilitate calibration and inter-reviewer reliability exercises, investigate and resolve inconsistent findings between reviewers, and maintain the review playbook and client-specific parameter documentation.
- Monitor platform override rates and own the human-in-the-loop policy for AI-assisted review, holding the team accountable to independent validation of every platform finding; serve as clinical point of contact to product and engineering, aggregating feedback and providing clinical sign-off on platform changes.
- Forecast review volume, allocate work across employees and contractors to meet contracted turnaround commitments, match assignments to credentials held, and escalate capacity shortfalls before they affect client billing.
- Serve as the escalation point for disputed findings, explaining clinical rationale and applicable CMS guidance to client clinical leadership, and represent review methodology and quality standards in client business reviews and onboarding.
- Maintain a credentialed consultant pool, match contract assignments to credentials and client scope, audit contractor deliverables against the same accuracy standard applied to employees, and coordinate with legal, compliance, and finance on contractor agreements — without directing a consultant’s hours, schedule, or method of performing review.
- Oversee client EMR access provisioning and deprovisioning, audit access and activity logs, ensure required security, HIPAA, and compliance training is completed before client work begins, and escalate suspected privacy incidents or unauthorized access immediately.
- Maintain current expertise in OASIS guidance, PDGM, CMS Conditions of Participation, HH QRP, HHVBP, and ICD-10-CM coding for home health, and own the process for absorbing guidance and code set changes into team standards, training, and platform logic.
Minimum Requirements list:
- Active, unrestricted Registered Nurse (RN) license required.
- Current COS-C (Certificate for OASIS Specialist – Clinical) or HCS-O (Home Care Clinical Specialist – OASIS) certification required at hire.
- Minimum of 5 years of clinical experience in Medicare-certified home health required.
- Minimum of 2 years of people leadership experience required, including hiring, performance management, and direct supervision of clinical staff.
- Demonstrated experience in OASIS review, clinical QA, coding audit, or documentation integrity required.
- Hands-on experience with one or more major home health EMR platforms required.
- Deep command of OASIS conventions, item intent, and time point requirements sufficient to adjudicate disagreements between experienced reviewers, and the ability to lead a remote, distributed team across multiple clients, EMRs, and time zones.
Work Environment:
- This is a hybrid role based in Jacksonville or Nashville.
- Primarily sedentary work performed in a remote or office setting, with extended periods of computer and screen use.
- May be client-facing; serves as the escalation point for disputed findings and represents review methodology to client leadership.
- Remote work requires a secure, private workspace and a reliable internet connection meeting Mosai and client security standards.
- Occasional travel for client meetings, team meetings, or industry conferences.
- Holds full authority over review standards, staffing, and the quality program, but no authority over client clinical records, submissions, or clinical practice.
Preferred Skills And Experience:
- BSN preferred; Associate’s degree in Nursing with equivalent leadership experience considered.
- Multi-state licensure or Nurse Licensure Compact participation preferred.
- Current HCS-D (Home Care Coding Specialist – Diagnosis) certification strongly preferred, given oversight of coding review work and audit of coding deliverables; BCHH-C or COQS considered as equivalents.
- Experience designing or running a clinical quality audit or calibration program strongly preferred; prior experience in an outsourced, vendor, or multi-client service environment strongly preferred.
- Experience managing or coordinating contract or contingent clinical staff preferred; experience with Homecare Homebase preferred.
- Experience with clinical software, decision support, or AI-assisted review tools preferred.
Physical Demands of Our Work Environment:
- This position uses a computer and other office equipment as needed to perform duties.
- The in-office noise level in the work environment is typical of that of an office.
- Frequent interruptions may be encountered throughout the workday.
- The employee is required to either stand or sit, talk and hear frequently required to use repetitive keying or hand motions.
- The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
We must remove EEO etc. Also remove "Learn more at https://www.mosai.com/" maybe keep as part of About Mosai? It's substantive? It's a link; could keep but it's not essential. Might be considered boilerplate? It's a link to learn more; maybe keep as part of About Mosai. The instruction: remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. The link is not boilerplate; it's a reference. Could keep.
We must not invent or summarize away detail. So we need to keep all details.
Now produce HTML fragment with sections.
We'll use
for each section heading.
Section headings: About the role (maybe combine About Mosai and Position Summary). Responsibilities (Job Duties). Requirements (Minimum Requirements). Skills (Preferred Skills And Experience). Work Environment (Work Environment). Physical Demands (Physical Demands of Our Work Environment).
We'll put content in
for prose, and
- for lists.
For About the role: we have two paragraphs: About Mosai description and Position Summary. Could combine into one
with both sentences? Better to keep as two
elements.
But we need to avoid duplication. We'll output:
About the role
Mosai™ is the intelligent care coordination platform that brings together the fragmented pieces of healthcare into a clear, connected picture. Like a mosaic, our platform unites data, people, and processes so providers can make better decisions, coordinate care in real time, and deliver improved outcomes. With Mosai, home-based care organizations can thrive in value-based care while giving every patient the right care, in the right place, at the right time. Learn more at https://www.mosai.com/
Leads the team that performs OASIS assessment review and ICD-10 coding review for Mosai’s home health clients, with direct people leadership over employed OASIS Reviewers and ICD-10 Coders and ownership of the quality standard applied to all review work, including work performed by contracted consultants. May be client-facing; serves as the escalation point that resolves disputed findings, represents review methodology to client leadership, and absorbs the client relationship so reviewers can stay focused on production and accuracy. Owns the human-in-the-loop standard for Mosai’s AI-assisted review platform, defining and auditing the expectation that licensed clinicians validate platform findings against the source record, and serves as the clinical counterpart to product and engineering on platform accuracy.
Then Responsibilities:
Responsibilities
- Recruit, interview, hire, and onboard OASIS Reviewers and ICD-10 Coders, verifying licensure and required credentials and supervising ramp on live review work to a defined accuracy threshold before independent assignment.
- Conduct one-on-ones, deliver performance feedback and reviews, manage underperformance through documented improvement plans, and coach reviewers on the quality of written recommendations.
- Define, document, and maintain the review accuracy standard, audit methodology, and sampling approach; run a recurring quality audit program across employees and contractors with findings, trending, and documented corrective action.
- Facilitate calibration and inter-reviewer reliability exercises, investigate and resolve inconsistent findings between reviewers, and maintain the review playbook and client-specific parameter documentation.
- Monitor platform override rates and own the human-in-the-loop policy for AI-assisted review, holding the team accountable to independent validation of every platform finding; serve as
for each section heading. Section headings: About the role (maybe combine About Mosai and Position Summary). Responsibilities (Job Duties). Requirements (Minimum Requirements). Skills (Preferred Skills And Experience). Work Environment (Work Environment). Physical Demands (Physical Demands of Our Work Environment). We'll put content in
for prose, and
- for lists.
For About the role: we have two paragraphs: About Mosai description and Position Summary. Could combine into one
with both sentences? Better to keep as two
elements. But we need to avoid duplication. We'll output:
About the role
Mosai™ is the intelligent care coordination platform that brings together the fragmented pieces of healthcare into a clear, connected picture. Like a mosaic, our platform unites data, people, and processes so providers can make better decisions, coordinate care in real time, and deliver improved outcomes. With Mosai, home-based care organizations can thrive in value-based care while giving every patient the right care, in the right place, at the right time. Learn more at https://www.mosai.com/
Leads the team that performs OASIS assessment review and ICD-10 coding review for Mosai’s home health clients, with direct people leadership over employed OASIS Reviewers and ICD-10 Coders and ownership of the quality standard applied to all review work, including work performed by contracted consultants. May be client-facing; serves as the escalation point that resolves disputed findings, represents review methodology to client leadership, and absorbs the client relationship so reviewers can stay focused on production and accuracy. Owns the human-in-the-loop standard for Mosai’s AI-assisted review platform, defining and auditing the expectation that licensed clinicians validate platform findings against the source record, and serves as the clinical counterpart to product and engineering on platform accuracy.
Then Responsibilities:Responsibilities
- Recruit, interview, hire, and onboard OASIS Reviewers and ICD-10 Coders, verifying licensure and required credentials and supervising ramp on live review work to a defined accuracy threshold before independent assignment.
- Conduct one-on-ones, deliver performance feedback and reviews, manage underperformance through documented improvement plans, and coach reviewers on the quality of written recommendations.
- Define, document, and maintain the review accuracy standard, audit methodology, and sampling approach; run a recurring quality audit program across employees and contractors with findings, trending, and documented corrective action.
- Facilitate calibration and inter-reviewer reliability exercises, investigate and resolve inconsistent findings between reviewers, and maintain the review playbook and client-specific parameter documentation.
- Monitor platform override rates and own the human-in-the-loop policy for AI-assisted review, holding the team accountable to independent validation of every platform finding; serve as