Auditing, Auto Insurance, Billing, Billing Records, CSS (Cascading Style Sheet), Certified Case Manager (CCM), Child Support, Childcare, Communication Skills, Data Management, Documentation, Driver's License, Firefighting, Healthcare, Healthcare Providers, Information Technology & Information Systems, Internal Audit, Maintain Compliance, Medical Billing, Microsoft Excel, Microsoft Office, Microsoft Word, Nursing, Nursing Credentials, Operational Support, Organizational Skills, Patient Care, Patient Charts, Pharmacy, Project/Program Coordination, Public Health, Public Safety, Registered Nurse (RN), Reimbursement, Reporting Skills, Time Management, Training/Teaching, Treatment Plan
Position Summary
The temporary nursing case manager for the CHANT program coordinates nursing case management services, monitors activities, and ensures compliance with state guidelines. Supports Maternal and Child Health initiatives through program operations, billing oversight, reporting, and collaboration with healthcare providers, patients, and community partners.
Pay Grade: 52H
Minimum Qualifications
- Two (2) years of full-time generalized nursing experience and graduation from an accredited associate's degree/diploma school of nursing; OR
- Bachelor''s degree from an accredited college or university in nursing; AND
- Licensed as an RN (Registered Nurse) in the state of Tennessee.
- Nursing case management experience is preferred.
- PROOF OF EDUCATION, TRAINING, AND/OR EXPERIENCE IS REQUIRED.
Duties and Responsibilities
- Reviews, approves, submits, and tracks billable claims and maintains billing documentation to ensure accurate reimbursement.
- Oversees pharmacy, treatment plan, and related claims in coordination with nursing staff to ensure accurate and timely weekly billing.
- Reviews and approves applications and recertifications for CHANT/CSS participants in accordance with policy guidelines.
- Monitors newborn screening data received from the State of Tennessee to identify potential program enrollments and ensure appropriate follow-up.
- Serves as a liaison with internal staff, healthcare providers, and community partners regarding billing, documentation, and program coordination.
- Supports CHANT program operations by coordinating patient services, monitoring program timelines, and tracking program outcomes and deliverables.
- Assists in conducting internal audits and reviews program documentation to ensure compliance with state guidelines and program requirements.
- Prepares required reports related to program activities, productivity, and compliance.
- Provides education and program information to patients, families, staff, and community partners.
- Performs other related duties as required or directed.
KSA's
- Knowledge of healthcare billing processes and review patient charts to assure optimal billing and documentation requirements.
- Knowledge of public health nursing principles, including maternal and child health and care coordination.
- Knowledge of social and economic factors that affect family dynamics.
- Strong organizational, communication, and data management skills.
- Ability to interpret and apply policies, procedures, and program guidelines and effectively relay information to staff, healthcare providers and community stakeholders.
- Proficient in Microsoft Office (word, excel), Redcap and other comparable county information systems.
Special Requirements
- Must possess a valid Tennessee driver''s license or secure one upon date of employment.
- Must have daily access to an operable automobile and meet county requirements for automobile insurance upon date of employment.
- Must be licensed or eligible for licensure in the State of Tennessee (licensure application must have been submitted upon date of employment).
- Must maintain all required licenses, certifications, and training credentials throughout the duration of employment.
Disclaimer
This position is subject to a background check for any convictions that have a substantial relationship to potential job duties. Only convictions that are substantially related to potential job duties will be considered and will not automatically disqualify the candidate.
Shelby County Resident Disclaimer
All employees hired after September 1, 1986, must be residents of Shelby County and shall continue to reside in the County as a condition of their employment. The residency requirement shall not apply to certain public safety/civil service employees. This means exemption from this policy is in effect for the following departments and positions: (1) Sheriff Deputy Patrol Officers, Deputy Jailers and Dispatchers, employed by the Sheriff Department, (2) Correction Officers employed by the Division of Corrections, (3) Firefighters, Paramedics and Dispatchers employed by the Shelby County Fire Department. The residency exemption for public safety/civil service employees does not include appointed positions with the Sheriff's Office, Division of Corrections, or the Fire Department.