Atrium Health Charlotte is seeking a Registered Nurse (RN) Case Management Director for a nursing job in Charlotte, North Carolina.
Job Description & Requirements
- Specialty: Case Management
- Discipline: RN
- Start Date: ASAP
- Duration: Ongoing
- Employment Type: Staff
Overview
Job Summary
Oversees components necessary to maximize access to services for the patient population served. Monitors payment processing system, audits and appeals, quality assurance, and compliance functions. Serves as a resource to administration for data analysis and regulatory information for use in operational decision making. Supervises staff.
Essential Functions
- Coordinates performance review for appropriateness of patient services and care team processes according to hospital standards and policies.
- Oversees development of facility, physician, and program specific outcome reports for the purposes of performance improvement.
- Reports actions to and obtains recommendations from an Advisory committee.
- Directs the coordination of payment system processes including maintaining and negotiating outcome of system contracts.
- Coordinates quarterly compliance audits, and the audits and appeals process to ensure highest probability of appropriate reimbursement for services delivered to our persons served.
- Tracks payer reimbursement patterns to ensure accurate and appropriate payment as needed.
- Directs the clinical care coordinators who interface with payers as needed to assure payment of services.
- Provides support and intervention as needed to ensure patients are able to access required services without financial hardship.
- Performs or delegates performance of documentation audits as needed to ensure clinical documentation meets compliance standards.
- Recommends and assists with changes to documentation systems to ensure compliance with the frequently changing requirements of the division.
Physical Requirements Frequent walking, standing, sitting. Ability to speak fluent English. Intact sense of sight, hearing, smell, touch, and finger dexterity. Critical thinking and ability to concentrate. Ability to lift and move reports weighing up to ten pounds. Flexibility in covering multiple sites.
Education, Experience and Certifications
Certificate of attendance to training workshop on the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI) preferred. Bachelor's Degree in Finance or Healthcare related field required; Master's degree preferred. At least 3 years of related work experience required.
Atrium Health Charlotte Job ID #144576. Posted job title: Director - Case Management
About Atrium Health Charlotte
Headquartered in Charlotte, NC, Atrium Health is now part of Advocate Health, the third-largest nonprofit, integrated health system in the United States, which was created from the combination with Advocate Aurora Health. In the Southeast Region, Atrium Health provides care under the Atrium Health name in Charlotte, NC, Atrium Health Wake Forest Baptist name in the Winston-Salem, NC, region, as well as Atrium Health Navicent and Atrium Health Floyd in Georgia and Alabama. Together, we are committed to providing equitable care for all. Annually, Advocate Health provides nearly $5 billion in community benefits.
Atrium Health Wake Forest Baptist
Atrium Health Wake Forest Baptist is a pre-eminent academic health system based in Winston-Salem, North Carolina. Atrium Health Wake Forest Baptist is part of Advocate Health, which is headquartered in Charlotte, North Carolina, and is the fifth-largest nonprofit health system in the United States, created from the combination of Atrium Health and Advocate Aurora Health. Atrium Health Wake Forest Baptist's two main components are an integrated clinical system - anchored by Atrium Health Wake Forest Baptist Medical Center, an 885-bed tertiary-care hospital in Winston-Salem - that includes Brenner Children's Hospital, five community hospitals, more than 300 primary and specialty care locations and more than 2,700 physicians; and Wake Forest School of Medicine, the academic core of Atrium Health Enterprise and a recognized leader in experiential medical education and groundbreaking research that includes Wake Forest Innovations, a commercialization enterprise focused on advancing health care through new medical technologies and biomedical discovery.
Atrium Health Navicent
Atrium Health Navicent is the leading provider of healthcare in central and south Georgia and is committed to its mission of elevating health and well-being through compassionate care. Atrium Health Navicent is part of Advocate Health, which is headquartered in Charlotte, North Carolina, and is the third-largest nonprofit health system in the United States, created from the combination of Atrium Health and Advocate Aurora Health. Atrium Health Navicent provides high-quality, personalized care in 53 specialties at more than 50 facilities throughout the region. As part of the largest, integrated, nonprofit health system in the Southeast, it is also able to tap into some of the nation's leading medical experts and specialists with Atrium Health, allowing it to provide the best care close to home - including advanced innovations in virtual medicine and care. Throughout its 125-year history in the community, Atrium Health Navicent has remained dedicated to enhancing health and wellness for individuals throughout the region through nationally recognized quality care, community health initiatives and collaborative partnerships. It is also one of the leading teaching hospitals in the region, helping to ensure viability for rural health care for the next generation.
Atrium Health Floyd
Atrium Health Floyd Medical Center is a 304-bed, full-service hospital located in Rome, Georgia. Serving as the main campus for Atrium Health Floyd, this hospital provides a certified Chest Pain Center, a designated Bariatric Surgery Center of Excellence and a Breast Imaging Center of Excellence. Atrium Health Floyd also is home to a state-designated Level II Trauma Center and a Level III Neonatal Intensive Care Unit, and has specialty centers for pediatrics, and wound care and hyperbaric therapy.
Benefits
- Medical benefits
- Vision benefits
- Dental benefits
- Life insurance
- 401k retirement plan
- Health savings account
Keywords:
Case Management, Healthcare, Registered Nurse, Patient Services, Healthcare Compliance, Data Analysis, Clinical Care, Quality Assurance, Financial Reimbursement, Leadership
