Clinical Operations Manager RN
6 days ago
We are seeking a highly skilled and experienced Clinical Operations Manager RN to join our team at Las Palmas Medical Center. As a key member of our healthcare team, you will be responsible for providing overall coordination in the delivery of medical services and discharge planning for a specified patient population.
Key Responsibilities- Utilization Review: Performs concurrent and retrospective review of patient medical records for purposes of utilization review, compliance with requirements of external review agencies, and quality assurance agencies.
- Discharge Planning: Promotes a cooperative and supportive relationship as liaison with patient, family, facility staff, physicians, funding representatives, and community agencies.
- Communication: Communicates proactively and cooperatively with Patient Access, Patient Account Services, and Central Verification Office personnel to ensure proper pre-certification and consistency of admissions status designation between physician order and EMR.
- Clinical Justification: Provides required clinical justification to third-party payers to obtain recertification for continued hospitalization and treatment.
- Liaison: Serves as a liaison between third-party payers, patient access, PAS, and CVO to ensure communication of all pertinent information regarding level of care, billing, and reimbursement.
- Financial Resources: Works with the patient and family to identify alternate financial resources available to meet the cost of necessary post-discharge needs or to recommend alternate care options when necessary funding is unavailable.
- Appeals Process: Initiates an expedited appeals process with payers and communicates with denials management regarding anticipated or verified denials and cooperates with denials management to provide additional clinical information for appeals.
- Education: Educates patient and family on case manager role and process for contacting the case manager for questions.
- Discharge Planning Coordination: Coordinates the integration of social services/case management functions into the patient care, discharge, and home planning processes with other hospital departments, external service organizations, agencies, and healthcare facilities.
- Collaboration: Collaborates with clinical staff in the development and execution of the plan of care and achievement of goals.
- Interdisciplinary Rounds: Facilitates interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education, and identify post-hospital needs.
- Patient Advocacy: Serves as a patient advocate by enhancing a collaborative relationship to maximize the patient's and family's ability to make informed decisions.
- Referral Process: Facilitates the referral process of next level of care.
- RN Licensure: RN licensure in the state of TX or Compact State.
- Education: Associates Degree or BSN completion within 3 years of hire date.
- Experience: Prefer three-five years clinical experience within an acute healthcare setting with recent work history in acute care case management role or related healthcare experience.
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Clinical Operations Manager, RN
4 weeks ago
El Paso, Texas, United States El Paso Children's Hospital Full timeJob SummaryWe are seeking a highly skilled and experienced Clinical Operations Manager, RN to join our team at El Paso Children's Hospital. As a key member of our healthcare team, you will be responsible for providing coordination of care for patients, managing assigned staff, and ensuring the smooth operation of our multispecialty clinic.Key...
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Clinical Operations Manager, RN
4 weeks ago
El Paso, Texas, United States El Paso Children's Hospital Full timeJob SummaryWe are seeking a highly skilled and experienced Clinical Operations Manager, RN to join our team at El Paso Children's Hospital. As a key member of our healthcare team, you will be responsible for providing coordination of care for patients, managing assigned staff, and ensuring the smooth operation of our multispecialty clinic.Key...
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Clinical Operations Manager, RN
4 weeks ago
El Paso, Texas, United States El Paso Children's Hospital Full timeJob SummaryWe are seeking a highly skilled and experienced Clinical Operations Manager, RN to join our team at El Paso Children's Hospital. As a key member of our healthcare team, you will be responsible for providing coordination of care for patients, managing assigned staff, and ensuring the smooth operation of our multispecialty clinic.Key...
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Clinical Operations Manager, RN
2 weeks ago
El Paso, Texas, United States El Paso Children's Hospital Full timeJob SummaryWe are seeking a highly skilled and experienced Specialty Clinic Coordinator, RN to join our team at El Paso Children's Hospital. This is a full-time, regular position that requires a strong background in healthcare administration and leadership.Key ResponsibilitiesProvide coordination of care for patients of the hospital/physician practice,...
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Clinical Operations Manager, RN
3 weeks ago
El Paso, Texas, United States El Paso Children's Hospital Full timeJob SummaryWe are seeking a highly skilled Clinical Operations Manager, RN to join our team at El Paso Children's Hospital. As a key member of our healthcare team, you will be responsible for coordinating patient care and managing assigned staff.Key ResponsibilitiesProvide leadership and guidance to healthcare professionals, ensuring effective communication...
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Clinical Operations Manager, RN
4 weeks ago
El Paso, Texas, United States El Paso Children's Hospital Full timeJob SummaryWe are seeking a highly skilled Clinical Operations Manager, RN to join our team at El Paso Children's Hospital. As a key member of our healthcare team, you will be responsible for coordinating patient care and managing assigned staff.Key ResponsibilitiesProvide leadership and guidance to healthcare professionals, ensuring seamless patient care...
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Clinical Operations Manager, RN
4 weeks ago
El Paso, Texas, United States El Paso Children's Hospital Full timeJob SummaryWe are seeking a highly skilled Clinical Operations Manager, RN to join our team at El Paso Children's Hospital. As a key member of our healthcare team, you will be responsible for coordinating patient care and managing assigned staff.Key ResponsibilitiesProvide leadership and guidance to healthcare professionals, ensuring seamless patient care...
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Clinical Operations Manager, RN
3 weeks ago
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Clinical Operations Coordinator, RN
1 month ago
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Clinical Operations Manager
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Clinical Operations Coordinator, RN
3 days ago
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Clinical Operations Manager
6 days ago
El Paso, Texas, United States Las Palmas Medical Center Full timeJob Summary:Las Palmas Medical Center is seeking a highly skilled and experienced Manager of Case Management RN to join our team. As a key member of our healthcare team, you will be responsible for providing overall coordination in the delivery of medical services and discharge planning for a specified patient population.Key Responsibilities:Conduct...
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Clinical Case Manager RN
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Clinical Operations Coordinator
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El Paso, Texas, United States University Medical Center of El Paso Full timeJob SummaryAs a key member of the University Medical Center of El Paso team, the Operating Room Nurse Manager will provide strategic support to the Department and Nurse Managers in the management of specialized areas of practice within the Operating Room. This role will be responsible for managing the service line surgery schedule, ordering and maintaining...
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Clinical Case Manager RN, FT Days Rotating
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El Paso, Texas, United States Jobot Full timeJob OverviewWe are seeking an experienced Clinical Chart Review Registered Nurse to join our team at a leading Academic Medical Center & Trauma Center. As a Clinical Chart Review RN, you will collaborate with CDI Specialists, Coders, and Providers to provide secondary case review and ensure accurate and thorough clinical documentation.Key...
