New Orleans, Louisiana
Registered Nurse, Senior Case Management Leader Job Opening in New Orleans, Louisiana - Registered Nurse, Senior Case Management Leader (Senior Director/Associate Vice President/Vice President), Clinical Revenue Cycle Operations-New Orleans, LA area
Interested in joining a fast-growing company that delivers exemplary clinical revenue cycle results to our clients without taking call, working weekends, or holidays? We are looking for an experienced Case Management senior leader who is hyper-focused on delivering consistent, superb results to our clients. Our definition of the clinical revenue cycle encompasses all of the typical aspects of the clinical revenue cycle including virtual, concurrent utilization review, clinical appeals, government audit (RAC) resolution, precertification, retrospective Medicaid reviews status post eligibility and other clinical solutions that differentiate us in the market place. Qualified candidates must be able to demonstrate a proven track record of delivering excellent results on key process indicators of the aforementioned. You will focus on the development, performance and growth of your teams and the organization as a whole. Our comprehensive benefit package is competitive; including but not limited to, paid time off, health, life and disability insurance, and a 401K retirement savings plan with an employer match after one year of service.
Qualifications:
Must possess current RN license, BSN required, Masters level preferred
8+ Years of Clinical Case Management (Payer or Hospital environment) experience with at least 5 years of steadily advancing leadership roles
Proven and demonstrated success as a senior (Senior Director/Associate Vice President/Vice President or commensurate level) level leader in the Payer or Hospital environment
Possesses a deep knowledge of medical necessity criteria including MCG and/or InterQual, both preferred
Experience in defending government audits such as RAC and medical necessity appeals
Ability to work across multiple to achieve results
Strong understanding of how clinical operations such as Case Management and Revenue Integrity (HIM) impact the hospital revenue cycle
Demonstrated mathematical / analytical aptitude with the ability to translate operational concepts into measurable results; ability to consistently deliver strong results
Experience working in multiple EMR/Patient accounting environments, Case Management documentation platforms and adjunct systems
Action-oriented, results-oriented, "take charge" attitude, capable of developing a strong business case for client or company actions
Ability to become a trusted partner to our clients and colleagues while anticipating their needs
Ability to quickly recognize, develop and execute process efficiencies while measuring impact of such efficiencies
Ability to interact at the executive level with our clients and colleagues relative to all forms of communication
Job Type: Full-time
Job Location:
New Orleans, LA
Required experience:
Clinical Case Management: 8 years
Leadership: 5 years
Required license or certification:
Registered Nurse (RN)
|
