Responsible for the managed care post-payment audits including Medicare Managed Care. Develop training and education for issues identified by managed care audits. Maintain integrity of audit database and assist in financial and clinical reporting of activity.
RN with understanding of patient status i.e IP, Observation, OP. Minimum of three years RN work experience. Previous case management experience helpful. Excel experience required.
BLS is required for any RN, LPN, PCT, Patient Transporter or other direct patient care provider. Emergency Department, Intensive Care Units, PACU, Medical Emergency Team and Anesthesia require ACLS. Pediatrics, SICU, Emergency Department and Medical Emergency Team also require PALS