Weekends and one rotating day during the week Working in collaboration with the patient/family/legal representative, social workers, physicians, and interdisciplinary team, the RN case manager is accountable for assessing, coordinating and facilitating patient progression through the continuum of care in an efficient, cost effective manner. The RN Case Manager must achieve this through early assessment of pre-admission level of care, post hospital discharge needs, review of available resource and timely, focused communication with the healthcare team and patient/family/legal representative. Required Skills/Qualifications/Training/Experience: Minimum 3-5 years acute care case management experience, with demonstrated skills in utilization review Demonstrated ability to use critical thinking and problem solving skills in facilitating safe and timely patient transitions of care Excellent communication skills and positive interpersonal dynamic in working with a variety of stakeholders across the care continuum Solid knowledge of all insurance plan regulations including CMS/Medicaid to ensure compliance with all required processes and documentation Ability to garner and utilize information effectively to develop and modify patient plan of care Strong analytical ability to interpret patient-related information, evaluate appropriateness of continued stay and/or need for ancillary services, and to reassess discharge planning needs based on daily assessment. Ability to successfully utilize industry accepted utilization and or medical management criteria in patient status decision making Self-starter able to function independently within the scope of position and licensure, as well as department policies and established goals Excellent computer skills to accurately document requisite information to support patient status and medical necessity Preferred Skills/Qualifications/Training/Experience: Experience in Meditech and Cerner a plus Denials management a plus Educational Requirements: RN Graduate of an accredited school of nursing required; BSN/MSN preferred License/Certification: RN with current Massachusetts license required CCM (Certified Case Manager) Preferred ACMA (Accredited Case Manager) Preferred Age Specific Criteria: Ability to effectively communicate to all age levels served within the scope of the position/assigned areas. Ability to Meet Job Performance Expectations: Must have the ability to perform the essential functions of the position without posing a direct threat to the health and safety of themselves or other individuals in the workplace, with or without a reasonable accommodation.
...The purpose of this position is to help in rendering service to the patient population. The Medical Billing Specialist must be flexible and able to multi-task. The position must also be knowledgeable as to how their job functions are integrated with Billing Specialist,...
...physicians, and interdisciplinary team, the RN case manager is accountable for assessing,... ...RN Graduate of an accredited school of nursing required; BSN/MSN preferredLicense/Certification... ...stakeholders, in person as well as via telephone and electronicallyAbility to interact...
...We Are: Since 1906, New Balance has empowered people through sport and craftsmanship to create positive change in communities... ...bold action today. JOB MISSION: As a member of the Global Marketing team, this role reports to the Global Key Account Senior Marketing...
...assesses, implements or delegates, plans, and evaluates total nursing care and functions in accordance with established philosophy,... ...Rewards: (Labor & Delivery RN )~ Pay depends on location and experience. ~ Health Insurance Coverage ~401k matching ~ We are offering...
...in ways that continue to set us apart. Role Overview: We're searching for a Remote Experienced Seamstress to supplement our sewing needs over the next 2-3 months. We are looking for someone available between 10 - 20 hours a week with a particular focus in commercial...