Concurrent review Nurse Manager (Hybrid)
CT. Licensed RN with Clinical Documentation Improvement Expertise and Staff Management experience will provide support to the of Clinical Staff of under five Nurses who are responsible for the hospital's documentation Improvement program.
Work closely with team members to perform audits of their work and opportunities for education, as well as opportunities for Physician education. Work closely with the Coding and Quality teams on initiatives as assigned.
Performs concurrent and retrospective second level reviews on specific types of opportunities including Cases of low acuity discharges to hospice and mortalities, low acuity DRGs with long LOS, specific DRG opportunities based on analytics, PSIs, HACs, etc.
Track software issues with process tools and coordinate with IT on updates.
Track query escalation process, CDS/Coder collaboration, etc.
Lead weekly huddles or monthly meetings .
Provide feedback and educational growth opportunities for staff members.
Conduct regular reviews of CDI queries and provide coaching and feedback. Identify DRG mismatches and collaborate with Coding team on reconciling. Provide feedback to physician advisor(s) on provider engagement/response. Serve as main point of contact for external and internal CDI data requests.
SKILLS and REQUIREMENTS
Licensed Registered Nurse (RN) in the State of CONNECTICUT
Inpatient Clinical Experience
Advanced Concurrent Review background
Advanced EMR (EPIC) documentation background
Advanced Clinical Coding, Revenue Cycle experience
Coding and or Denials software such as 3M 360
Understanding of how to avoid/reduce denials, delays and coder training time for a smoother patient billing process
5 Years Minimum Management background in Concurrent Review
Medical Chart Review experience
Assertive and courteous personality traits to facilitate ongoing physician communication.
Working knowledge of inpatient admission criteria.
Other Certifications (Preferred) RHIA - American Health Information Management Association (AHIMA) Or RHIT - Or CCS
Full time 40 Hours on site 2 days / 3 days remote (central CT. Location)
If you are an RN with Coding and Clinical Documentation Mangement experience You may reach out for a brief phone call to discuss this opportunity
Attn:
Krisha Morander, Clinical/Recruitment (Direct Hire /Permanent Placement
Krisham@Jmorrissey.com
INDI