Nurse (Quality & Safety)-DHA

2 weeks ago

Gallup, United States Indian Health Service Full time

This position is being announced concurrently under Excepted Service Examining Plan (ESEP)/Merit Promotion (MP) procedures. Please review vacancy announcement number IHS-24-GA-12447539-ESEP/MP; for eligibility requirements. NOTE: Applicants must apply separately for each announcement in order to be considered under ESEP/MP.
Process for assessing and monitoring patient charts and health status to determine appropriateness and completeness of medical documentation, length of stay, intensity of services, and allocation and utilization of resources for patient care.
Provide concurrent or retro review to third party payers as needed for certification of admission days as needed. Communicate with providers and nursing staff to ensure accurate clinical documentation is present in the electronic health records.
Review denials for appeal, when received from Case Management. Collaborate with Business Office and Billing staff to track and review ensuring prior authorization has been completed on admission for third party eligible cases.
Works with the Health System Administrator and Clinical Director to resolve complex medical documentation problems. Utilizes Registered Nurse Training and expertise to prevent denials by instructing and training the practitioners regarding complete and appropriate medical documentation for the patient's status and level of care, and that the documentation meets applicable guidelines, standards, policies, procedures.
Assures that the Utilization Review program meets the Joint Commission and third party payer's guidelines and regulatory requirements.
Analyzes and projects fiscal year third party billing/collection based on inpatient per diem rate, outpatient visit rate, Diagnosis Related Groups (DRG) case mix average for inpatient and outpatient, workloads, and available Medicare, Medicaid, and Private insurance population data.

  • Nurse DHA

    1 month ago

    Gallup, New Mexico, United States Department Of Health And Human Services Full time

    Summary This position is located in the Medical/Surgical and Women's Health Units Division of Nursing Services within Gallup Indian Medical Center, Gallup, NM. These positions provide a limited range of monitoring and administration of nursing care, therapies and treatments. Evaluate and develop individual nursing plan of care by implementing the plan to...

  • Nurse DHA

    1 month ago

    Gallup, United States Department Of Health And Human Services Full time

    Summary This position is located in the Medical/Surgical and Women's Health Units Division of Nursing Services within Gallup Indian Medical Center, Gallup, NM. These positions provide a limited range of monitoring and administration of nursing care, therapies and treatments. Evaluate and...

  • Nurse (Quality & Safety)-DHA

    2 weeks ago

    Gallup, New Mexico, United States Indian Health Service Full time

    This position is being announced concurrently under Excepted Service Examining Plan (ESEP)/Merit Promotion (MP) procedures. Please review vacancy announcement number IHS-24-GA ESEP/MP; for eligibility requirements.NOTE:Applicants must apply separately for each announcement in order to be considered under ESEP/MP.Process for assessing and monitoring patient...

  • Supervisory Nurse

    7 days ago

    Gallup, United States Indian Health Service Full time

    06/24/2024: This position is being re-announced to solicit additional candidates. Applicants who previously applied to this announcement need not re-apply unless submitting updated information and/or missing forms. This position will be Open Until Filled. **This position is being announced concurrently under Excepted Service Examining Plan and Merit...

  • Lead Nurse

    2 weeks ago

    Gallup, United States Indian Health Service Full time

    **This position is being announced concurrently under Excepted Service Examining Plan and Merit Promotion procedures. Please review vacancy announcement number IHS-24-GA-12441523-ESEP/MP; for eligibility requirements. NOTE: Applicants must apply separately for each announcement in order to be considered.** Provides professional nursing care and assists with...

  • Assistant Supervisory Nurse

    2 weeks ago

    Gallup, United States Indian Health Service Full time

    05/13/2024: This position is being re-announced to solicit additional candidates. Applicants who previously applied to this announcement need not re-apply unless submitting updated information and/or missing forms. This position will be Open Until Filled. **This position is being announced concurrently under Excepted Service Examining Plan and Merit...

  • Supervisory Nurse

    4 weeks ago

    Gallup, United States Department Of Health And Human Services Full time

    Summary The position is located in the Division of Nursing Services, Inpatient Department, at Gallup Indian Medical Center in Gallup, NM . This position functions as a member of the Nursing Executive Team to manage, plan, and organize nursing care to ensure compliance with polices,...

  • Supervisory Pharmacist

    7 days ago

    Gallup, United States Indian Health Service Full time

    Orients, trains, and evaluates competencies and rates performance on the pharmacy technicians. Assures proper program staffing, program quality, productivity an effectiveness and assesses the need to revise or develop programmatic changes to meet patient care needs. Creates, evaluates and implements competencies to comply with required training and...

  • Nurse (Clinical Coach Coordinator) DHA

    4 weeks ago

    Gallup, United States Indian Health Service Full time

    04/23/2024: This position is being re-announced to solicit additional candidates. Applicants who previously applied to this announcement need not re-apply unless submitting updated information and/or missing forms. This position will be Open Until Filled. **This position is being announced concurrently under Excepted Service Examining Plan and Merit...

  • Nurse (Clinical Coach Coordinator) DHA

    1 month ago

    Gallup, New Mexico, United States Indian Health Service Full time

    04/23/2024: This position is being re-announced to solicit additional candidates. Applicants who previously applied to this announcement need not re-apply unless submitting updated information and/or missing forms. This position will be Open Until Filled.This position is being announced concurrently under Excepted Service Examining Plan and Merit Promotion...

  • Assistant Supervisory Nurse

    1 month ago

    Gallup, United States Indian Health Service Full time

    Summary This position is located at the Gallup Indian Medical Center, Division of Nursing Services, Medical/Surgical (2 West) Department, Gallup, NM. Assistant Supervisory Nurse is responsible for supervising, managing, directing, coordinating, providing leadership, and evaluating the...

  • Assistant Supervisory Nurse

    4 weeks ago

    Gallup, United States Department Of Health And Human Services Full time

    Summary This position is located at the Gallup Indian Medical Center, Division of Nursing Services, Perioperative Services Department, Gallup, NM. Assistant Supervisory Nurse is responsible for supervising, managing, directing, coordinating, providing leadership, and evaluating the...

  • Nurse (Diabetes) - DHA

    2 weeks ago

    Gallup, New Mexico, United States Department Of Health And Human Services Full time

    Summary This position is located at Gallup Indian Medical Center(GIMC), Diabetes Program, Gallup, NM. The purpose of the position is to provide nursing expertise and leadership in assessing, planning, implementing, and evaluating care provided to individuals with or at risk for Type 2 Diabetes Mellitus. Provides diabetes training and consultation to service...

  • Nurse (Diabetes) - DHA

    4 weeks ago

    Gallup, United States Department Of Health And Human Services Full time

    Summary This position is located at Gallup Indian Medical Center(GIMC), Diabetes Program, Gallup, NM. The purpose of the position is to provide nursing expertise and leadership in assessing, planning, implementing, and evaluating care provided to individuals with or at risk for Type 2...

  • Nurse (Diabetes) - DHA

    3 weeks ago

    Gallup, New Mexico, United States Department Of Health And Human Services Full time

    Summary This position is located at Gallup Indian Medical Center(GIMC), Diabetes Program, Gallup, NM. The purpose of the position is to provide nursing expertise and leadership in assessing, planning, implementing, and evaluating care provided to individuals with or at risk for Type 2 Diabetes Mellitus. Provides diabetes training and consultation to service...

  • Supervisory Nurse Educator

    4 weeks ago

    Gallup, United States Indian Health Service Full time

    **This position is being announced concurrently under Excepted Service Examining Plan and Merit Promotion procedures. Please review vacancy announcement number IHS-24-GA-12423676-ESEP/MP; for eligibility requirements. NOTE: Applicants must Responsible for oversight, coordinating, implementing and evaluating the nursing education programs for inpatient and...

  • Supervisory Nurse

    1 month ago

    Gallup, United States Indian Health Service Full time

    04/17/2024: This position is being re-announced to solicit additional candidates. Applicants who previously applied to this announcement need not re-apply unless submitting updated information and/or missing forms. This position will be Open Until Filled. **This position is being announced concurrently under Excepted Service Examining Plan and Merit...

  • Nurse (Educator EM) - DHA

    2 weeks ago

    Gallup, United States Indian Health Service Full time

    06/05/2024: This position is being re-announced to solicit additional candidates. Applicants who previously applied to this announcement need not re-apply unless submitting updated information and/or missing forms. This position will be Open Until Filled. **This position is being announced concurrently under Excepted Service Examining Plan and Merit...

  • Lead Nurse

    1 month ago

    Gallup, United States Indian Health Service Full time

    **This position is being announced concurrently under Excepted Service Examining Plan and Merit Promotion procedures. Please review vacancy announcement number IHS-24-GA-12405693-ESEP/MP; for eligibility requirements. NOTE: Applicants must apply separately for each announcement in order to be considered.** Provides guidance to employees, nurses and health...

  • Nurse (Educator EM) - DHA

    2 weeks ago

    Gallup, New Mexico, United States Indian Health Service Full time

    06/05/2024: This position is being re-announced to solicit additional candidates. Applicants who previously applied to this announcement need not re-apply unless submitting updated information and/or missing forms. This position will be Open Until Filled.This position is being announced concurrently under Excepted Service Examining Plan and Merit Promotion...