Your opportunity
The LVN – Home Health Recertification Review Nurse supports the Vytal Care Home Health Program by performing comprehensive chart reviews for Medicare home health recertifications. This role ensures documentation meets Medicare criteria, identifies gaps or missing elements required for compliance, and prepares recommendations for RN and provider review. The LVN works closely with the RN program lead and interdisciplinary team to ensure timely, accurate recertification decisions and maintain adherence to regulatory and organizational standards.
What You Will Do
Conduct thorough chart reviews for home health 60-day recertification periods based on Medicare Criteria (Medicare Benefit Policy Manual (Chapter 7: “Home Health Services”), Section 30 (“Conditions for Coverage of Home Health Services”)
Verify documentation supporting ongoing homebound status, skilled need, and clinical eligibility for recertification.
Review patient progress toward goals, frequency of visits, plan of care elements, and documentation submitted by home health agencies (HHAs).
Identify missing or incomplete documentation needed for recertification (e.g., face-to-face requirements, visit notes, updated OASIS, provider orders).
Prepare structured summaries and recommendations for the RN program lead and provider, ensuring clarity and completeness for final review.
Communicate with home health agencies to request missing documentation or clarify discrepancies in clinical notes.
Collaborate with the RN program lead to ensure timely completion of recertification reviews and compliance with internal workflows.
Participate in interdisciplinary team communication related to patient status, changes in condition, or documentation needs.
Maintain accurate and compliant documentation of all review activities according to program standards.
Escalate clinical concerns, significant changes in condition, or eligibility questions to the RN program lead or appropriate provider.
Support quality assurance and process improvement initiatives within the Home Health Recertification Program.
Utilize digital tools (EMRs, Point of Care systems, review checklists, and documentation trackers) proficiently and accurately.
What will make you successful here
Education:
Graduate of an accredited Licensed Vocational Nurse (LVN) program.
Experience:
Minimum of 5 years of experience in home health, care management, utilization review, or related clinical field.
Experience with Medicare home health documentation or certification/recertification processes preferred.
Licensure/Certifications:
Active, unencumbered LVN license in applicable state(s).
Knowledge/Skills/Abilities:
Familiarity with Medicare home health requirements (homebound status, skilled need, recertification cycles).
Strong attention to detail with excellent documentation review skills.
Ability to identify inconsistencies or gaps in clinical documentation and communicate findings clearly.
Strong written and verbal communication skills.
Ability to collaborate effectively with RNs, providers, and external home health agencies.
Proficiency with digital tools (EMR systems, MS Office, Google Workspace, documentation platforms).
Ability to maintain confidentiality and comply with HIPAA regulations.
Strong critical-thinking and problem-solving abilities.
Organized, flexible, and able to adjust to changing regulatory or workflow requirements.
Professionalism and commitment to high-quality patient care and regulatory compliance.
*Please note at no time during our screening, interview, or selection process do we ask for additional personal information (beyond your resume) or account/financial information. We will also never ask for you to purchase anything; nor will we ever interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com
*We fully embrace the power of AI and encourage innovative, responsible use of emerging technologies in our work. However, during the interview and assessment process, it’s essential that we evaluate your individual skills, problem-solving ability, and technical mastery without external assistance.
Candidates must complete all interviews and assessments independently.
Use of AI tools, platforms, or automated assistance during interviews or assessments is not permitted. Unauthorized use will result in immediate disqualification from the hiring process and withdrawal of employment consideration.
Our goal is to ensure a fair and accurate assessment of your true capabilities—the same creativity and critical thinking we value once you join our team.
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