http://www.clevelandclinic-jobs.com/go/Huron-Hospital-Jobs/28208/ View Huron Hospital Jobs at Cleveland Clinic Mon, 06 Sep 2010 15:09:15 GMT en-us /sites/clevelandclinic/images/CC_banner.jpg http://www.clevelandclinic-jobs.com/go/Huron-Hospital-Jobs/28208/ 720
Reference Title
HR Use Only:
Hospital: Cleveland Clinic East Market
Facility: Huron Hospital
Department: School of Nursing
Job Code: F2701E
Schedule: PRN
Shift: Variable
Hours: Variable
Job Details:

Adjunct Faculty - School of Nursing - Responsible for clinical and/or classroom instruction in specific course and other courses as assigned. Cooperates with all faculty to plan, implement and evaluate all courses within the curriculum. Participates in the faculty organization and in school functions. Continues professional development. Must be a graduate from an approved school of professional nursing, have a BSN or higher degree in nursing and at least 2 years professional nursing experience. Requirements preferred include a MSN, prior clinical and classroom teaching experience in a school of professional nursing and certification in a specialty area.

Category: Managerial/Professional/Physician]]> http://www.clevelandclinic-jobs.com/job/East-Cleveland-Clinical-Faculty-OH-44110/922982/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS http://www.clevelandclinic-jobs.com/job/East-Cleveland-Clinical-Faculty-OH-44110/922982/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS
Reference Title
HR Use Only:
Hospital: Cleveland Clinic East Market
Facility: Huron Hospital
Department: CASE MGMT/SOCIAL SERVICES
Job Code: T99262
Schedule: Full Time
Shift: Days
Hours: 8:30-5:30
Job Details:

General Summary:

Under the general direction of the Director of Care Management, supports denials, appeals, and compliance activities within the Care Management Department, including patient chart reviews and various audits supporting the Department and hospital in meeting regulatory requirements associated with Care Management. Supports policy development and implementation, strengthening staff?s understanding and compliance with policies. Works closely with Department leaders and staff within the Revenue Cycle to identify and develop broad performance improvement plans to address identified issues and areas of risk. Supports managed care activity in the form of appeal documentation and assists in the denial appeal process. Assists in the design of physician documentation improvements and the appeal defense process. Works in conjunction with the site Medical Directors, Care Managers, Patient Financial Services, Compliance Officers, and the Directors of Medical Records to evaluate and improve the denial management, documentation, and appeal process.


MINIMUM QUALIFICATIONS:

Education, Knowledge, Skills and Abilities

BSN or Bachelor's in related healthcare field preferred. Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the patient served. Must demonstrate knowledge of the principles of growth and development as it relates to the different life cycles. Excellent interpersonal communication and negotiation skills. Strong analytical, data management and PC skills. Current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement. Understanding of pre-acute and post-acute venues of care and post-acute community resources. Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components. Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families. Demonstrates commitment to Patient Experience process and the Behavioral Expectations in all interactions and in performing all job duties. Performs duties in a manner to promote quality patient care and customer service/satisfaction, while promoting safety, cost efficiency, and a commitment to the CQI process. Must possess through knowledge of governmental billing rules and regulations as well. Must possess the ability to analyze documentation. An extremely high degree of attention to accuracy and detail is required. Must have excellent verbal and written communication skills in order to develop relationships with physicians, medical records and management that cultivate mutual respect and confidence in the accuracy of the data developed. Expert in medical terminology and clinical data interpretation.

Required Length and Type of Experience

Minimum 3 to 5 years Care Management experience which would include acute med/surg experience required. Must have expertise with Interqual and Milliman and Roberston disease management ideologies. In-depth familiarity with third party billing requirements and regulations, billing documentation requirements preferred.

Required Licensure, Certification or Registry

Licensed Registered Nurse in the State of Ohio. Certified in Case Management required within one year of eligibility. InterQual certification a plus.

Required Physical and Environmental Demands

Manual dexterity to operate office equipment. Ability to live and transport up to 15 pounds. May require extended periods of standing, walking, or sitting. Good visual acuity through normal or corrected vision.

Category: RN/LPN/APN/Ambulatory/Other Nursing]]> http://www.clevelandclinic-jobs.com/job/East-Cleveland-Denials-Appeals-Nurse-Job-OH-44110/888164/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS http://www.clevelandclinic-jobs.com/job/East-Cleveland-Denials-Appeals-Nurse-Job-OH-44110/888164/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W%5FRSS