RN with Case Management Implementation- Nationwide
Job Description: Affiliated Computer Services, Inc. (ACS) is expertise in action™. We are a FORTUNE 500 company with 74,000 employees worldwide supporting client operations reaching more than 100 countries. We provide business process outsourcing and information technology solutions to world-class commercial and government clients. Our employees operate with integrity, and are flexible, reliable and responsive.
If you meet the requirements of this position and want to work for a world-class company with a great marketplace reputation, apply today.
POSITION
Provide expertise as a Registered Nurse (RN) and functional consultantto healthcare clients of ACS Healthcare Solutions. Implement case management systems,determine best practice roll-out, and conduct analysis or process redesign. Experience with Midas+ case management isdesired but Midas+ training is available for the ideal candidate. Travel up to 100% is required but not relocation.
Extensive knowledge of Case Management/Utilization Review/Discharge Planning
Case Management system implementation experience
Knowledgeable of Interqual/Robertson initial and concurrent review
Knowledgeable of Federal Regulations i.e. Medicare Primary and Secondary
Knowledgeable of Clinical Documentation used to support INP VS Observation
Provide education, medical staff, case managers, Utilization review. Patient financial services. Ancillary departments, nursing
Identify issues with documentation, medical necessity, coding, level of care
Development of policies and procedures related to findings related to RAC
Recommendation on tools that can assist in tracking of RAC, billing, denials and compliance tools
Knowledgeable of HIM processes and role as relates to coding
Knowledgeable of Financial Services Process as related to billing and denial
Experienced in performing denials and tracking
Experience working with CFO, CIO, Medical Directors, Compliance offices, clinical and non clinical staff
All other duties as assigned.
ACS is an Equal Opportunity Employer and does not Discriminate against any applicant on the basis of race, color, religion/creed, national origin, gender, or sex, marital status, age, disability, use of a guide dog or service animal, sexual orientation, military/veteran status, or any other status protected by Federal or State law or local ordinance. People with disabilities who need a reasonable accommodation to apply or compete for employment with ACS may request such accommodations by calling or by sending an e-mail to accommodations@acs-.
Extensive knowledge of Case Management/Utilization Review/Discharge Planning
Case Management system implementation experience
Knowledgeable of Interqual/Robertson initial and concurrent review
Knowledgeable of Federal Regulations i.e. Medicare Primary and Secondary
Knowledgeable of Clinical Documentation used to support INP VS Observation
Provide education, medical staff, case managers, Utilization review. Patient financial services. Ancillary departments, nursing
Identify issues with documentation, medical necessity, coding, level of care
Development of policies and procedures related to findings related to RAC
Recommendation on tools that can assist in tracking of RAC, billing, denials and compliance tools
Knowledgeable of HIM processes and role as relates to coding
Knowledgeable of Financial Services Process as related to billing and denial
Experienced in performing denials and tracking
Experience working with CFO, CIO, Medical Directors, Compliance offices, clinical and non clinical staff
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