Clinical Documentation Specialist - Peyton Resource Group : Job Details

This position evaluates patients receiving home health services to ensure ongoing eligibility and appropriate care. Serving as part of the interdisciplinary care team, this role advocates for patients by providing proactive outreach, coordinating care across providers, and supporting smooth transitions between care settings. Collaborate with primary care providers, home health agencies, hospitals, families, caregivers, and community healthcare partners to ensure quality, continuity, and patient-centered care.

Responsibilities

• Remain up to date on current home health coverage requirements and payer guidelines.
• Review and assess Home Health Plans of Care to determine medical necessity and continued eligibility.
• Lead and participate in case conferences with home health agencies to evaluate progress toward goals and develop safe discharge plans.
• Monitor that patient needs are being addressed, care plans are followed, and appropriate interventions are provided.
• Make recommendations to primary care providers regarding continuation or discharge of home health services.

Requirements:

• Registered Nurse in the state of Texas
• 2-3 years of managed care and/or care management experience preferred.