Oasis Reviewer - Home Health

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

Performs clinical review and validation of OASIS assessments on behalf of contracted home health agency clients, working within Mosai’s AI-assisted review platform and each client’s electronic medical record. Applies licensed clinical judgment to independently verify platform-generated findings against the source record and produce clear, defensible recommendations. May be assigned ICD-10 coding review as a secondary scope, based on credentials held and the services a given client has purchased. This is a production review role and is not client-facing; all questions, disagreements, and escalations route through Mosai clinical operations and the client services team.

Job Duties

• Conduct review using Mosai’s AI-assisted review platform, accessing source documentation in the platform and the client’s EMR as the assignment requires; independently verify every platform-generated finding against the record before including it in a recommendation.
• Review OASIS assessments across all required time points: Start of Care, Resumption of Care, Recertification, Transfer, and Discharge - validating responses against the current OASIS data set, CMS Guidance Manual, applicable skip logic, and CMS Quarterly OASIS Q&As.
• Verify internal consistency between OASIS responses and the supporting record, applying particular scrutiny to Section GG self-care and mobility items, cognitive and behavioral items, and case-mix-impacting M-items.
• Apply Patient-Driven Groupings Model (PDGM) requirements, including clinical grouping, functional impairment level, comorbidity adjustment, and LUPA exposure.
• Where credentialed, review primary and secondary diagnosis assignment against ICD-10-CM Official Guidelines and home health sequencing conventions as a secondary scope, escalating coding or OASIS conflicts to Mosai clinical operations.
• Produce written recommendations that state the item or code at issue, the supporting or conflicting documentation and its location in the record, applicable CMS or coding guidance, and clinical rationale — framed as compliant, non-leading requests that never direct a specific response.
• Enter recommendations through each client’s defined channel, meet contracted turnaround commitments, and track recommendations to closure.
• Work across multiple client agencies and EMR platforms, completing client-required onboarding and access provisioning before beginning review work for that client.
• Access and use protected health information only as necessary to perform assigned review work, consistent with HIPAA minimum necessary requirements and the applicable Business Associate Agreement; never enter, alter, or fabricate clinical documentation.
• Maintain review accuracy at or above the standard defined by Mosai clinical quality, participate in calibration exercises, and report platform false positives, missed findings, and out-of-date guidance references.

Minimum Requirements

• Active, unrestricted Registered Nurse (RN) license required, in the state or states necessary to support assigned client work.
• Associate’s degree in Nursing required.
• Current COS-C (Certificate for OASIS Specialist – Clinical) or HCS-O (Home Care Clinical Specialist – OASIS) certification required, held at time of hire.
• Minimum of 3 years of clinical experience in Medicare-certified home health required, including hands-on completion or review of OASIS assessments.
• Hands-on experience with at least one major home health EMR (for example Homecare Homebase, WellSky, Axxess, or KanTime) required.
• Demonstrated working knowledge of PDGM, HIPPS and case-mix assignment, LUPA thresholds, CMS Conditions of Participation, and OASIS-based quality measures.
• Ability to critically evaluate AI-generated findings and disagree with the platform when the record does not support it; strong written communication, high attention to detail, and the ability to work independently in a remote environment while meeting daily throughput targets.

Work Environment

This is a hybrid role based in Nashville or Jacksonville. Primarily sedentary work performed in a remote or office setting, with extended periods of computer and screen use.