for your career here. As a Registered Nurse, you can expect: flexibility for true work-life balanceopportunities for career growththe ability to build trusted nurse-patient relationshipsemployee-focused wellness and support programs If you love nursing and want to strengthen your experience, this is a great opportunity for you.
Responsibilities The Registered Nurse in Home Health provides and directs provisions of nursing care to patients in their homes as prescribed by the physician and in compliance with applicable laws, regulations, and agency policies. The Registered Nurse coordinates total plan of care with other health care professionals involved in care and helps to achieve and
maintain continuity of patient care by planning and exchanging information with physician, agency personnel, patient, family, and community resources. All done within a Point of Care setting.
Education and Experience License Requirements Current RN licensure in state of practice Current CPR certification Current Drivers License, vehicle insurance, and access to a dependable vehicle or public transportation Company Overview LHC Group is committed to a culture of diversity, equity and inclusion and is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, interaction, interactionual orientation, gender identity,
national origin, disability, status as a protected veteran, or any legally other protected characteristic.
Southeast Alabama Home Care a part of LHC Group family of providers - the preferred post-acute care partner for hospitals, physicians, and families nationwide. We deliver high-quality, cost-effective care that supports our patients when and where they need it. From our home health, hospice, and community-based services to inpatient care at our clinics and hospitals, our mission is to reach more patients and families with effective and efficient healthcare. More hospitals, physicians, and families choose LHC Group because we are united by a single shared purpose: It's all about helping people.
For more details: jobs-search. org/insurance_enterprise-c424337/registered-nurse-rn-home-health-enterprise_i1959777108
reflects clinical treatment, decisions, diagnoses and level of service rendered. The UR/CDI nurse serves as a resource for guidance and support to all members of the health care team on appropriate status, documentation guidelines, and assisting ongoing education and training related to improving clinical documentation.
Job Duties Utilization Review: Perform admission, concurrent and retrospective medical reviews. Ensures effective and efficient payer communications to establish appropriate reimbursement for servcies. Functions as the liaison between various hospital departments, medical staff and payers on issues related to medical necessity for admission and continued stay. The UR/CDI
nurse maintains open, transparent and clear lines of communication with physician advisors. Provides Utilization Management education to clinical staff as needed.
Applies standardized criteria and guidelines to assist appropriate admission determinations and and patient class assignment (i. e. observation, inpatient and outpatient). Assist in monitoring resources while maintaining uncompromisingly high quality of care. Responsible for maintaining and ensuring the admission process remains fully compliant with Medicare and Medicaid regulations. Acts as a resource to the Care Management department regarding utilization, insurance and payer resolution matters. Identifies areas of opportunity
regarding payment eligibility for clinical services and recommends corrective action.
Participates in UR meetings. Clinical Documentation Integrity: The Clinical Documentation Integrity Nurse is responsible for extensive record review and interaction with physicians, HIM coding professionals, nursing staff and other patient care givers to ensure accurate representation of patients conditions and severity of illness is captured in the patient's medical record Responsible for active participation in team meetings and development of clinical documentation guidelines, and education of staff on these guidelines, on an ongoing basis. Provides extensive and accurate reviews of medical records within specified timelines.
Recognizes opportunities for documentation improvement to support severity of illness and quality of care, formulates clinically credible documentation clarifications/queries and follows up for responses as needed. Seeks clarification from physicians, nursing, and other staff in cases where documentation is absent, ambiguous, or contradictory. Provides provider education regarding query management within the electronic health record, and other CDI topics. Meets program quality and productivity guidelines and standards. Participates in Coding/CDI meetings.
Collaborates with inpatient coders to determine appropriate Diagnosis Related Groups (MS-DRG, APR-DRGs, etc. ) and ICD-10 code assignment. Collaborates with Coding and Quality Management teams to appropriately identify and develop compliant queries regarding Hospital Acquired Conditions (HAC) and Patient Safety Indicators (PSI). Meets revenue cycle goals, Key Performance Indicators (KPIs), quality and productivity standards. An experienced CDI nurse may assist in training and mentoring new CDI nurse to become acclimated to new environment, and understanding internal policies, procedures, standard work, and workflows.
Abides by The Ethical Standards for Clinical Documentation Improvement (CDI). Professionals as set forth by the American Health Information Management Association. Participates in other assignments and special projects as assigned. For more details: jobs-search. org/insurance_hartford-c424197/urcdi-nurse-per-diem-hartford_i1949953086
