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Healthcare Case Manager

1 month ago

Oxon Hill, Maryland, United States Inova Health System Full time
Job Title: Community Health Nurse

Inova Health System is seeking a skilled and dedicated Community Health Nurse to join our team.

Job Summary

The Community Health Nurse will be responsible for coordinating and performing administrative activities to support the Case Management department. This includes arranging services for assigned patient populations, ensuring that appropriate continuing care services are in place for patient transitions.

Key Responsibilities
  • Coordinate and perform administrative activities to support the Case Management department.
  • Arrange services for assigned patient populations, including Home Health, Durable Medical Equipment, Ambulance, Housing, Skilled Nursing Facility, and others.
  • Communicate and document accurate clinical/financial information in both verbal and written forms.
  • Deliver and document delivery of regulatory forms, such as the mandated Observation letter, and the Medicare IMM notifications.
  • Address and solve provider and payor issues quickly with support from Case Management staff.
  • Distribute and document delivery of mandated Observation and Medicare IMM/HINN letters as directed.
  • Communicate financial and clinical information to clinicians, patients, families, care team members, and external customers.
  • Document clinical and financial patient information to assist with discharge, planning, and access to continuing care services.
  • Communicate with payor and document detailed instructions on billing, authorization, and utilization of services.
  • Complete state and federal forms related to patient level of care, according to regulatory standards, to assist with patient transition.
  • Manage and maintain state required UAI filings as well as all accounts receivable/payable functions for the department to ensure timely payments.
  • Maintain and monitor the system Case Management program, including reimbursement of all negotiated vendor contracts.
  • Provide support to the strategic planning and business development initiatives of the department.
  • Reviews and approves time/attendance for department staff on a biweekly basis.
  • Submits any identified time/pay adjustments to Payroll in a timely manner.
  • Maintains records of all system Case Management files and acts as liaison to Foundation, auxiliary, and external vendors.
  • Assists in monitoring the operational budget, in collaboration with department Director, related to funds disbursement and reconciliation.
  • Tracks and monitors accounting for budgets, capital requests, travel funds, and business expenses.
Requirements
  • Experience: 2 years of relevant experience.
  • Education: High School or GED.
Benefits
  • Health, Vision, and Dental Coverage.
  • Tuition reimbursement and Educational Assistance.
  • Student loan assistance – up to $10,000.
  • State-of-the-art medical and training facilities.
  • Paid parental leave for birth/adoption of a child.
  • Retirement benefits with match from day one.
  • Free Parking to all employees.
  • Exclusive savings opportunities to in-store events, theme parks, discounts, movie tickets, and local offerings.