Memorial Health
Location
Springfield, Massachusetts
Salary
$33 - $53 / HOUR
Performs clinical reviews of patient records to evaluate acute care service utilization and supports medical necessity for reimbursement. Facilitates physician documentation and provides data for quality improvement initiatives.
Requires an Associate Degree in Nursing and current Illinois RN licensure. Candidates must have 3-5 years of recent acute care, home health, or case management experience.
12pm - 12am or 8:00-4:30pm Performs clinical review of patient records to evaluate the utilization of acute care services. Communicates to third party payors to support the medical necessity of the hospital admission for services reimbursement. Ensures the patient care team is aware of general length of stay requirements for all patients. Facilitates physician documentation through concurrent interaction with physicians to support reimbursement and clinical severity is captured for the service rendered to patients receiving hospital care. Provides clinical knowledge and data collection for quality improvement initiatives. Optimizes reimbursement for acute care services. This is NOT a remote position.
Education: Associates Degree in Nursing. Bachelor’s Degree in Nursing preferred. Evidence of continuing professional development Licensure/Certification/Registry: Current RN licensure in the State of Illinois required Experience: Minimum of 3- 5 years of recent acute care and/or home health nursing or case management experience required. Previous utilization review experience strongly preferred. Other Knowledge/Skills/Abilities: Understanding of healthcare reimbursement mechanisms preferred. Strong oral and written communication skills. Demonstrated adaptability to changes in health care environment with proactive problem solving attitudes Understanding of the principles of performance improvement, team collaboration, and conflict resolution
Patient Care Technician, 2E Oncology
Radiologic Technologist Assistant
Patient Care Technician, 7C ICU
Radiologic Technologist Assistant
Echo Tech Students - Horizons Program
Phlebotomist/Lab Assistant I (Days)
Patient Care Technician, 2E Oncology
Radiologic Technologist Assistant
Intensive Care Unit Nurse - Per Diem
Patient Care Technician, 7C ICU
Radiologic Technologist Assistant
In-Home Therapy (IHT) Clinician
LPN Hospice
Patient Care Aide Weekend-Nursing Administration-FT-1st shift
Certified Registered Nurse Anesthetist (CRNA) - Bonus Offered!
Registered Nurse
Licensed Practical Nurse (LPN) FT Day - Up to $1,500 Bonus
Staff Nurse, Critical Care Services - I Blue (Cardiac Step Down)