Manager, Clinical Review Services

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.

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• 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.

• 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 escalation 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 escalated 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…