RN Case Manager - Revenue Cycle
About The Position
Facilitates progress through the continuum of care, from Pre-Admission through Discharge. Provides feedback to payors on patient’s clinical status and secures approvals for additional days of stay. Monitors quality standards as determined by the Performance Improvement Plan and Medical Staff Quality Indicators. Evaluates patients for discharge planning needs and appropriately directs the patient’s care. Monitors resource consumption for most effective use. Identifies teaching and psychosocial concerns for the best patient outcome. Assists in aggregating data for quality trending and Infection Control surveillance. Functions as Patient Advocate to assist patients in resolving concerns.
Requirements
- Registered Nurse (RN) license
- Experience in case management or revenue cycle
- Knowledge of clinical status and payor feedback
- Understanding of quality standards, Performance Improvement Plan, and Medical Staff Quality Indicators
- Ability to evaluate discharge planning needs
- Skills in resource management
- Ability to identify teaching and psychosocial concerns
- Experience in data aggregation for quality trending and Infection Control surveillance
- Patient advocacy skills
Responsibilities
- Facilitate progress through the continuum of care, from Pre-Admission through Discharge.
- Provide feedback to payors on patient’s clinical status and secure approvals for additional days of stay.
- Monitor quality standards as determined by the Performance Improvement Plan and Medical Staff Quality Indicators.
- Evaluate patients for discharge planning needs and appropriately direct the patient’s care.
- Monitor resource consumption for most effective use.
- Identify teaching and psychosocial concerns for the best patient outcome.
- Assist in aggregating data for quality trending and Infection Control surveillance.
- Function as Patient Advocate to assist patients in resolving concerns.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
