Nurse Director
4 weeks ago
Med Career Solutions is seeking a highly skilled and experienced RN Director of Case Management to join our team in El Paso, TX.
Job Summary:The RN Director of Case Management will provide overall coordination in the delivery of medical services and discharge planning for a specified patient population. This role will perform concurrent and retrospective review of patient medical records for purposes of utilization review, compliance with requirements of external review agencies, and quality assurance agencies.
Key Responsibilities:- Communicate 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.
- Communicate known changes to patient payer information and other relevant financial characteristics of coverage to appropriate admissions and billing personnel.
- Serve 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.
- Work 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.
- Proactively initiate an expedited appeals process with payers and communicate with denials management regarding anticipated or verified denials and cooperate with denials management to provide additional clinical information for appeals.
- Associate's degree or BSN completion within 3 years of hire date.
- Must have Case Management experience within the acute care setting, minimum 2 years.
Med Career Solutions offers a comprehensive benefits package, including a competitive salary, relocation bonus, and unmatched full benefits package. Our benefits include:
- Comprehensive medical coverage, including prescription drug and behavioral health coverage.
- Free telemedicine services and free AirMed medical transportation.
- Dental and vision benefits, life and disability coverage, flexible spending accounts, and supplemental health protection plans.
- 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service).
- Employee Stock Purchase Plan with 10% off facility Healthcare stock.
- Family support through fertility and family building benefits with Progyny and adoption assistance.
- Referral services for child, elder, and pet care, home and auto repair, event planning, and more.
- Consumer discounts through Abenity.
- Retirement readiness, rollover assistance services, and preferred banking partnerships.
- Education assistance (tuition, student loan, certification support, dependent scholarships).
- Colleague recognition program.
- Time Away from Work Program (paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence).
- Employee Health Assistance Fund offers free employee-only coverage to full-time and part-time colleagues based on income.
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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