RN CASE MANAGER - Davis Health System
Elkins, WV 26241
About the Job
Position Summary: Review of medical charts in order to justify appropriate billing to insurance companies for inpatient or observation services. Communicates the complexity of the patient’s illness and the treatment provided to the insurance company to obtain authorization for services. Works closely with physicians to help provide education on clinical documentation improvement. Completes psychosocial screenings on all patients that are determined to be at risk for post hospitalization needs. Assists patients and families with advance directives and end of life goal clarification. Communicates with WV DHHR (APS/CPS) when elements of abuse or neglect are present. Requires strong problem solving abilities, self-motivation, resourceful thinking, and strong clinical nursing background.
Position Qualifications: Minimum Education: Associate’s Degree in Nursing Preferred Education: Bachelor’s Degree in Nursing Required Courses(s)/Training: 2 years of acute hospital experience preferred. Experience in discharge planning or utilization review specialty area is preferred. Required Credentials: Current WV RN license Required Certification(s): BLS ACM certification within two years Skills: Strong communication skills Strong teamwork skills Strong clinical nursing background Problem solving ability Self-Motivating quality Being comfortable with Electronic Health Records Physical Demands: Occasional prolonged standing/walking Contact with patients under a wide variety of circumstances Exposure to unpleasant elements (accidents, injuries, and illness) Subject to varying and unpredictable situations Handles emergency or crisis situations Fast Paced Environment- pressure d/t multiple calls and inquiries
PI249615514
Source : Davis Health System