RN Recovery Nurse Specialist - Revenue Cycle Solutions Team - Full Time - Days - Work from Home
Company: Ochsner Clinic Foundation
Location: New Orleans
Posted on: May 3, 2024
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Job Description:
We've made a lot of progress since opening the doors in 1942,
but one thing has never changed - our commitment to serve, heal,
lead, educate, andinnovate.Webelieve that every award earned, every
record broken and every patient helped is because of the dedicated
employees who fill our hallways. At Ochsner, whether you work with
patients every day or support those who do, you are making a
difference and that matters. Come make a difference at Ochsner
Health and discover your future today! This job applies clinical
expertise as well as knowledge of utilization and discharge
planning criteria to review medical information of prior
hospitalized patients that are being reviewed via the regulatory
audit process. Identifies issues and problems such as inappropriate
admissions and non-acute hospital days which may adversely impact
quality patient care, appropriate utilization of hospital
resources, or optimal financial reimbursement to Ochsner Health
System (OHS). Functions as a liaison with the department Vice
President/Manager of Regulatory Audits and ensures compliance with
regulations and alternative level of care options affecting OHS
revenue as it relates to all medical necessity audits. Education
Required -Registered Nurse Diploma Preferred - Associate's or
Bachelor's degree in Nursing Work Experience Required -3 years
Hospital based experience in the delivery of patient care as an RN.
Experience in Case Management, Utilization Review and/or Discharge
Planning .either in the Acute Care environment or Managed Care
environment. Experience responding to change positively and work
calmly as well as efficiently in high pressure situations.
Experience functioning independently and working well within a team
setting. Preferred - Experience in Appeal/Denial Management
Certifications Required - Current State of Louisiana Registered
Nurse (RN) License Preferred -Certification in Case Management
(CCM) or Certified Professional in Utilization Review, Utilization
Management or Health Care Management (CPUR, CPUM, and CPHM)
Knowledge Skills and Abilities (KSAs)
Physical and Environmental Demands
The physical demands described here are representative of those
that must be met by an employee to successfully perform the
essential functions of this job. Reasonable accommodations may be
made to enable individuals with disabilities to perform the
essential functions. Medium Work - Exerting 20 to 50 pounds of
force occasionally, and/or 10 to 25 pounds of force frequently,
and/or greater than negligible up to 10 pounds of force constantly
to move objects. (Constantly: activity or condition exists 2/3 or
more of the time) to move objects. Physical demand requirements are
in excess of those for Sedentary Work. Even though the weight
lifted may be only a negligible amount, a job should be rated Light
Work: (1) when it requires walking or standing to a significant
degree; or (2) when it requires sitting most of the time but
entails pushing and/or pulling of arm or leg controls; and/or (3)
when the job requires working at a production rate pace entailing
the constant pushing and/or pulling of materials even though the
weight of those materials is negligible. NOTE: The constant stress
and strain of maintaining a production rate pace, especially in an
industrial setting, can be and is physically demanding of a worker
even though the amount of force exerted is negligible. Mechanical
lifting devices (carts, dollies, etc.) or team lifts should be
utilized.
Must be able to stoop, bend, reach and grab with arms and hands,
manual dexterity.
Must be able to stand for prolonged periods of time.
Must be able to work a flexible work schedule (e.g. 24/7, weekend,
holiday, on call availability).
Must be able to travel throughout and between facilities. Duties
performed routinely require exposure to blood, body fluid and
tissue. The incumbent works in a patient care area; works in an
area where patients enter; works directly with patients; and/or
works with specimens that could contain diseases. There may be an
occupational risk for exposure to all communicable diseases. Are
you ready to make a difference? Apply Today! Ochsner Health does
not consider an individual an applicant until they have formally
applied to the open position on this careers website. Individuals
who reside in and will work from the following areas are not
eligible for remote work position: Colorado, California,
Washington, New York, and Washington D.C. Ochsner Health endeavors
to make our site accessible to all users. If you would like to
contact us regarding the accessibility of our website, or if you
need an accommodation to complete the application process, please
contact our HR Employee Solution Center at 504-842-4748 (select
option 1) or. This contact information is for accommodation
requests only and cannot be used to inquire about the status of
applications. We are proud to be an Equal Employment Opportunity
and Affirmative Action employer. We are committed to the principles
of equal employment opportunity and providing a workplace that is
free from discrimination based on race, color, creed, religion,
pregnancy status, pregnancy-related conditions, national origin,
ancestry, mental or physical disability, medical condition, age,
veteran status, military status, citizenship status, marital
status, familial status, sexual orientation, gender, gender
identity or expression, genetic information, political affiliation,
unemployment status, or any other characteristic protected under
applicable federal, state or local law. These protections extend to
applicants and all employment related decisions. View theand its,
as well as thefor more information.
Keywords: Ochsner Clinic Foundation, Gulf Port , RN Recovery Nurse Specialist - Revenue Cycle Solutions Team - Full Time - Days - Work from Home, Healthcare , New Orleans, Mississippi
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