Case Manager Nurse Salary in Atlanta, GA

Location: REMOTESalary: $80,000.00 USD Annually - $95,000.00 USD AnnuallyDescription: Our client is currently seeking a Remote Nurse Practitioner Case Manager The Judge Group is looking for a REMOTE Case Manager to work in the Largo Florida Area Nurse Care Manager - Fracture Prevention Fulltime Remote - Eastern Time Zone Full Benefits You'll be an ideal candidate if you: 1. Have relevant education and licensure Graduate of an accredited RN and NP Program (Master's Degree) 2. Current FL RN License OR •Current FL APRN, Nurse Practitioner Certification and NP Furnishing Number 3.Current National certification from an approved organization (American Nurses Credentialing Center, American Academy of Nurse Practitioners, National Certification Board of Pediatric Practitioners, 4. National Certification Corporation for Obstetric, Gynecologic and Neonatal Nursing Specialties)•Have relevant work experience 3 years of clinical experience with a minimum of 2 years of clinical case management experience Partnered successfully with physicians to enable outstanding care delivery •Are seeking a professional environment to grow, learn, and make an impact Possess a desire to improve the experience of patients, providers, and partners Are a natural problem solver, self-starter, and creative thinker In this role you will:•Be the cornerstone of our Fracture Prevention Program, focused on diagnosing and treating patients who are high-risk for costly, life-altering fractures Send your updated resume to [email protected] for consideration I look forward to hearing from you, Contact: [email protected] job and many more are available through The Judge Group. Find us on the web at www.judge.com

Location: REMOTEDescription: Our client is currently seeking a RN Care Manager I for one of our top clients!Remote position but must reside in SC!Type: ContractCompensation: Competitive & dependent on experienceJob Description: Responsible for collaborating with healthcare providers and/or consumer to drive personalized health management and improve health outcomes for optimal consumers. Performs care management activities within the scope of licensure for members with complex and chronic care needs. Primary duties may include, but are not limited to: Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out of network services, and appropriateness of treatment setting and level of care. Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance. Collaborates with providers to assess consumer needs for early identification of and proactive planning for discharge. Conducts clinical assessment to develop goals that address individual needs in order to develop and implement a care plan. Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Requirements:Requires 3 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in SC required. Multi-state licensure is required if this individual is providing services in multiple states. Home health/discharge planning experience preferred. AS/BS in nursing preferred. Certification as a Case Manager is preferred. For URAC accredited areas, the following applies: Current and active RN license required in applicable state(s) that allows for an independent assessment to be conducted within their scope of practice. Requires 3 years full-time equivalent of direct clinical care experience to the consumer, 5 years full-time equivalent of direct clinical care experience to the consumer preferred or any combination of education and experience, which would provide an equivalent background, Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager from the approved list of certifications or a BS in a health or human services related field also preferred. If qualified and interested, please send an updated resume to [email protected] for immediate consideration.Contact: [email protected] job and many more are available through The Judge Group. Find us on the web at www.judge.com

Location: REMOTESalary: Depends on ExperienceDescription: The Judge Group is looking for Nurse Practitioners to perform in-home health assessments on Medicare Advantage Members in your area with one of the largest healthcare providers. Pay - HIGHLY competitive, paid per assessment - dependent upon experience. Contract - ongoing (no end date) Schedule - PART TIME OR FULL TIME (2 to 7 days a week) - flexible schedules (can be made around another current position). All training and equipment are provided by the client. W2 position paid weekly. Overview: The provider will review and observe a member's current health, medical history, medication adherence, social environment and other risks in about a 1-hour in-home visit. This provides unmatched insight into a member's overall health and well-being that can be difficult to capture during routine office visits. Responsibilities Adult/Geriatric Assessments, medical history, diagnosis and treatment, health education, physician referrals, case management referrals, follow-up and clear documentation according to guidelines and protocols Collaborate with physicians, case managers, social workers, family members, key caregivers and any appropriate ancillary medical personnel Collaborate with Primary Care Physician (PCP) on patient education, provide follow-up Qualifications: Have a Minimum of 6 months experience as a Nurse Practitioner - Will consider new grads Master's Degree required OR commensurate experience and satisfactory completion of NP licensure Board certified by the AANP, ANCC or the AACCN in an approved specialty Have a current BLS, ACLS or CPR certification Have strong computer skills and familiarity with Employee health/medical record software Board Certifications accepted: Acute Care Adult Health Family Health Oncology If you or someone you know is interested, please reach out to Anthony DaSilva at [email protected] with an updated resume. I look forward to hearing from you. Contact: [email protected] job and many more are available through The Judge Group. Find us on the web at www.judge.com

Shepherd Center, located in Atlanta, Georgia, is a private, not-for-profit hospital specializing in medical treatment, research and rehabilitation for people with spinal cord injury, brain injury, stroke, multiple sclerosis, spine and chronic pain, and other neuromuscular conditions. Join us in our mission to help people with a temporary or permanent disability, rebuild their lives with hope, independence and dignity, advocating for their full inclusion in all aspects of community life. At Shepherd Center, you'll discover a diverse and inclusive environment, enlightened leadership, a culture of teamwork, professionalism and mutual respect. If you are seeking career advancement, continuing education opportunities coupled with a welcoming and fun workplace, competitive compensation and employment benefits, visit our careers page to explore current openings. The Complex Concussion Clinic offers comprehensive and patient-centered rehabilitation and services to treat concussions and assist you in returning to work, school, athletics, and leisure and daily activities.Job Responsibilities:Supports advocacy for patients and their families by promoting high standards of patient care, participating in program evaluation and development and other designated department related tasks.Works closely with clinic physicians to address patient issues (therapy goals, vocational interests/goals, and patient financial status) as they arise in clinic setting.Works with patient and family to develop a mutually acceptable plan of care to maximize the potential of the patient, family, and community.Bridges communication between providers, patients and families, members of the interdisciplinary team, and outside agencies to assure high-quality care that meets the patient's needs and is delivered in a cost-effective and timely manner.Coordinates physician orders to outside suppliers, including home health, durable medical equipment, and supplies.Collaborates with inter and intra-departmental supervisory staff to ensure quality patient care and functions within the scope of Shepherd Center's philosophy, policies and procedures.Promotes and facilitates a multidisciplinary approach to coordinate care and plan operations among disciplines.Acts as resource for case manager associates and practitioners and assists with problem solving and difficult cases. Serves as a resource person of expertise within department, Shepherd Center, and the community.Manages requests for medication assistance, forms, and letters that come to the outpatient case management office.Provides the team with active support by meeting with patient's, families, and vendors to create the best outcomes for our patient treatment plans.Provides direct assistance with customer service issues to work to create a win-win for all parties involved.Completes regular rounding opportunities and assists with yearly evaluations on case management associates.Provide education, guidance, and support post discharge, with a strong focus on medical, financial and psychosocial needs.Completes thorough and accurate documentation in electronic records.Coordinates language services when interpretation needs arise in the clinic.Maintains appropriate certification.Understand ethical considerations, patient in crisis in relations to finances, neglect, abuse, psychosocial needs, etc.Maintains knowledge of current relevant state and federal regulations, Joint Commission standards and criteria, and documentation requirements. Practices proper safety techniques in accordance with Center and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system. Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Performs other duties as assigned.Minimum Required Education: Bachelor's degree (allied health, nursing, or related field) or appropriate state licensure. Required Minimum Certification: Certification in Case Management (Case Management Society of America, American Case Management Association, American Nurses Credentialing Center, or equivalent certification within two years of position start date. Individuals hired prior to October 1, 2022 are grandfathered in and must obtain their CCM or ACM within two years from October 1, 2022. Required Minimum Experience: Minimum of two (2) years broad clinical experience. Experience in care coordination, case management, discharge planning and utilization review preferred. Required Minimum Skills: Effective time management skills. Excellent communication skills, both verbal and written.Effective decision making/problem-solving skills and creativity in problem solving.Demonstrated effective critical thinking skills and ability to anticipate patient discharge needs.Understanding of the interdisciplinary team approach and rehabilitation environment.Moderate to expert computer skills.Working knowledge of financial aspects of third-party payors and reimbursement Preferred Qualifications: N/A Physical Demands: Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time or exerting up to 15 pounds of force occasionally or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body. Working Conditions: Some potential for exposure to blood and body fluids. The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be an exhaustive list of all job duties performed by the personnel so classified.

About UsIntegrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.At IntegrityM, we offer a culture of opportunity, recognition, collaboration, compassion and supporting our community. We thrive off of these fundamental elements that make IntegrityM a great place to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees' professional development. Large company perks...Small company feel!We are now seeking a Medical Review Manager to join our team. This is a contingent position.RequirementsMinimum three (3) years' experience practicing nursing as a licensed Registered NurseMinimum of three (3) years' experience of supervisory/managerial experience in the health insurance industryBachelor's degree in Nursing is required. Registered Nurse LicensureCertified Professional Coder (CPC) Certification or the ability to obtain this certification or similar coding certification within 12 months of appointment

Shepherd Center, located in Atlanta, Georgia, is a private, not-for-profit hospital specializing in medical treatment, research and rehabilitation for people with spinal cord injury, brain injury, stroke, multiple sclerosis, spine and chronic pain, and other neuromuscular conditions. Join us in our mission to help people with a temporary or permanent disability, rebuild their lives with hope, independence and dignity, advocating for their full inclusion in all aspects of community life. At Shepherd Center, you'll discover a diverse and inclusive environment, enlightened leadership, a culture of teamwork, professionalism and mutual respect. If you are seeking career advancement, continuing education opportunities coupled with a welcoming and fun workplace, competitive compensation and employment benefits, visit our careers page to explore current openings. The Laboratory Manager is responsible for daily operations in a laboratory, including hiring and training staff, implementing quality systems, evaluating test performance, eliminating hazards from lab environment, and ensuring appropriate test method selection.Job Responsibilities:Lead in the development, validation, and implementation of new procedures and methods for clinical laboratory applications and will establish strategies, and ensure projects and goals are met.Works closely with administration, clinical laboratory medical director, department directors and physicians to deliver quality laboratory services for the Center including outpatient clinics and laboratory support services, such as couriers and phlebotomy.Ensures orientation and continuing education activities are provided for team members which address employee safety, infection control, job training and leadership development.Participates in education programs and professional organizations to maintain professional growth and provides department and staff with new information.Seeks input and recommendations from staff on ways to improve laboratory operations.Meets with faculty, nursing, physicians and other customers regarding laboratory operations/service and education/research.Prepares operational, statistical reports for regulatory agencies, productivity monitoring and benchmarking activities. Reviews reports to assist in making fact-based decisions.Prepares reports identifying quality improvement and laboratory accomplishments.Oversees test fee schedule and cost analysis.Provides leadership to achieve financial and operating objectives within time frames and budgets.Directs, establishes, and plans the overall policies and goals for a hospital's laboratory services.Writes and updates procedures and manuals as needed and reviews them annually to ensure that employees have current information needed to perform tests and procedures. Assist with overseeing clinical laboratory staff and all technical operations of the laboratory to include MRI/CT, Nursing and Respiratory.Directs staff in the performance of their duties and responsibilities including oversight for hiring, training, competency assessment, performance evaluations and goal setting.Planning, organizing, and directing various research and development projects.Develop and implement installation of new or improved laboratory techniques.Lead and manage the implementation and completion of new procedures, methods, and instruments, as well as ensuring all training, accreditation, and competency standards are met.Oversee complex projects, analyze results, and provide recommendations based on findings.Define and monitor quality control and quality assurance programs and maintain necessary documentation and ensure methods are in full compliance with policies and procedures.Provide guidance and expertise in the analysis and interpretation of reports to clients.Serve as technical supervisor for all Point of Care.Keeps abreast of regulatory changes, ensures Quality Assurance and safety compliance with federal regulations and certifying agencies.Ensures preparation for inspections, maintenance of accurate records, procedure manuals, record storage and monitors results of proficiency testing.May serve on, or chair laboratory and hospital committees or clinical pathways. Makes decisions focused on customer service. Serves as liaison between laboratory and patients, physicians, nurses, staff and other institutions.Effectively manages employee performance; addresses problems by listening to employees and providing employees with feedback, identifying ways to develop skills to perform their job effectively. Communicates job expectations to employees and ensures employee competency and timely performance evaluations/ documentation.Regularly reviews year to date expenses and variances. Investigates and justifies variance and implements corrective actions. Practices proper safety techniques in accordance with Center and departmental policies and procedures. Responsible for the reporting of employee/patient/visitor injuries or accidents, or other safety issues to the supervisor and in the occurrence notification system. Monitors and ensures compliance with all regulatory requirements, organizational standards, and policies and procedures related to area of responsibility. Identifies potential risk areas within area of responsibility and supports problem resolution process. Required Minimum Education Bachelor's Degree from a four-year college or university. Required Minimum Certification Certification as Medical Technology or Clinical Laboratory Scientist by ASCP (American Society of Clinical Pathologist) or AMT (American Medical Technologist). Required Minimum Experience 10 years of medical technology or healthcare experience of which four years in a supervisory capacity is preferred. Experience in a hospital setting. Required Minimum Skills Completes orientation and initial assessment of competency successfully by determined due date. Completes mandatory education and annual competency assessment requirements by determined due date Ability to exercise sound judgment and make decisions in a manner consistent with the essential job functions and company policies.Ability to effectively cope with change and manage stressful situations.Ability to manage multiple priorities while maintaining a positive attitude. Must be able to work without direct supervision. Strong organizational, customer service, and teamwork skillsStrong interpersonal and problem-solving skills Excellent communication and Organizational Skills. Preferred Qualifications Master's Degree in Business Administration or Master's in Health Science. Working Conditions Normal patient care environment. Some potential for exposure to blood and body fluids. Some potential exposure to infectious viruses.

Overview The Licensed Practical Nurse (LPN) - Family Medicine at Vinings is a proactive member of an interdisciplinary team of licensed and unlicensed care givers who ensure that patients, families and significant others receive individualized high quality, safe patient care. It is expected that all RN Clinical Nurses - are licensed, knowledgeable and uphold the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association. Schedule:Full Time Shift: Day Shift Level: 6+ years of experience Success Profile Find out what it takes to succeed as a Licensed Practical Nurse (LPN) - Family Medicine at Vinings: Collaborative Time Efficient Organized Critical Thinker Attention to Detail Compassionate Benefits that Reflect Your Contributions Your Pay A compensation program designed for fair and equitable pay. Your Future Secure your future with plans that also include an employer match. Plans and guidance for the future. Your Wellness Traditional healthcare benefits combined with progressive wellness programs to help you be your best self!. Your Joy Special and unique benefits and programs ensuring a balanced life and a workplace culture built on trust. Job Details Facility: WellStar Family Medicine at Vinings JubileeOverviewThe Licensed Practical Nurse (LPN) functions under the direction of the Physician, Nurse Supervisor and/or Practice/Office Manager. Recognizes patient's needs and symptoms in advance. Provides care for the patient under the physician's direction. Includes preparing patient for exams, assisting during treatments, coordinating tests and follow-up care, and recording treatment in medical record. Assists with patient and family education. Demonstrates competency and skills to serve patients of all ages including neonate, infant, child, adolescent, adult, and geriatric populations. Performs other duties, as necessary.It is expected that all LPNs are licensed, knowledgeable and uphold the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implement the Nursing Practice Standards and Code for the Licensed Practical/Vocational Nurses put forth by the National Federation of Licensed Practical Nurses, Inc. (NFLPN). As a member of the patient services team, it is expected that the individual upholds the voice of the patient, system policies and procedures, while supporting service excellence goals.ResponsibilitiesCore Responsibilites and Essential Functions Professional Practice and Responsibility* Exemplary Practice and Outcomes * Practices within the scope and in accordance with Nursing Practice Standards and Code for the Licensed Practical/Vocational Nurses put forth by the National Federation of Licensed Practical Nurses, Inc. (NFLPN).* Promotes health promotion in the performance of clinical care using evidence-based practice, uses analytical/critical thinking and ensuring that care is individualized; coordinating care through effective partnerships recognizing that caring is central to achieve optimal patient care outcomes. * Practices using current clinical practice standards. * Teamwork and Collaboration * Coordinates the delivery and documentation of safe quality patient care that promotes the professional care delivery model. This includes but is not limited to diverse and inclusive interdisciplinary communication methods (interdisciplinary rounds, case review, etc.), completion of timely documentation and promotion of a respectful, inclusive clinical environment. * Demonstrates teamwork and collaboration by practicing in a manner that is fiscally responsible and promotes the recruitment and retention of all healthcare team members. * Professional Development and Initiative * Completes all initial and ongoing professional competency assessments, required mandatory education, and licensure requirements. * Serves as a preceptor and/or or mentor for other practical nurses (and unlicensed staff or students) to ensure that there is a current and future qualified workforce, modeling the professional practice of nursing and creating a healthy work environment. * May delegate tasks to unlicensed staff, as appropriate and within their scope of practice.* Evidence Based Practice and Research * Promotes Evidence based practice, nursing research and performance improvement in nursing. Participates in shared decision-making groups and committees as able. * Upholds all health care system/organizational policies and procedures and clinical competencies put forth by this job description and professional association including legal, regulatory and accreditation requirements and standards ensuring by way of example, such goals as TJC Patient Safety Goals and WellStar Health Systems' safety absolutes. * Participates in data collection and poses relevant clinical questions to advance evidence-based practice. Consults appropriate experts and uses appropriate resources and evidence to address practice questions. Practice Operations* Provide direct patient care as directed by provider. * Proactively plans for the care of patients across the care continuum via pre-visit planning processes. * Contributes to financial viability through service quality and clinical excellence.* May serve as liaison with nursing leadership as it relates to clinical operations and quality initiatives. Patient Liaison and Advocate* Provides relationship-based patient centered care that is consistent with population specific characteristics (e.g., age, gender, disease, etc.) in a culturally sensitive manner.* Always partners with the patient, significant others and/or family (as appropriate) to promote a comfortable and safe environment for the delivery of care, making the patient's goals the focus of the plan of care.Required for All Jobs Performs other duties as assigned Complies with all WellStar Health System policies, standards of work, and code of conduct. QualificationsRequired Minimum Education Graduate from a practical or vocational nursing program. Required Required Minimum Experience Previous healthcare experience Preferred and Experience in ambulatory, outpatient setting Preferred and In some cases, hospital-based experience may substitute. Required and Specific experience in practice specialty Required Required Minimum Skills Must be organized and manage time efficiently to assure patient comfort and satisfaction. Attentiveness to detail. Strong interpersonal/human relations skills, interact positively with staff, providers, and patients. Must be able to communicate and understand verbal and written English language, optimize the use of technology to support clinical care and holds basic computer skills. The employee should also be able to adhere to the WellStar Credo and Code of Conduct. Required Minimum License(s) and Certification(s)Lic Practical Nurse Required Basic Life Support Required BLS - Instructor Required BLS - Provisional Required Additional Licenses and Certifications Current/active license as a Licensed Practical Nurse in the State of Georgia. Required Must have a current BLS card from the American Heart Association prior to hire date. Required ACLS/PALS may be required in some practice areas. Share the opportunity Mission, Vision & Values At a time when the healthcare industry is changing rapidly, Wellstar remains committed to exceeding patients' and team members' expectations, while transforming healthcare delivery.Our Mission To enhance the health and well-being of every person we serve.Our Vision Deliver worldclass health care to every person, every time.Our Values We serve with compassion We pursue excellence We honor every voice

Overview The Registered Nurse (RN) - Internal Medicine is a proactive member of an interdisciplinary team of licensed and unlicensed care givers who ensure that patients, families and significant others receive individualized high quality, safe patient care. It is expected that all RN Clinical Nurses - are licensed, knowledgeable and uphold the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association. Schedule:Full Time Shift: Day Shift Level: 6+ years of experience Success Profile Find out what it takes to succeed as a Registered Nurse (RN) - Internal Medicine: Collaborative Time Efficient Organized Critical Thinker Attention to Detail Compassionate Benefits that Reflect Your Contributions Your Pay A compensation program designed for fair and equitable pay. Your Future Secure your future with plans that also include an employer match. Plans and guidance for the future. Your Wellness Traditional healthcare benefits combined with progressive wellness programs to help you be your best self!. Your Joy Special and unique benefits and programs ensuring a balanced life and a workplace culture built on trust. Job Details Facility: Wellstar Family Medicine - Atlanta (3890 Redwine)OverviewThe RN Clinical Nurse is a proactive member of an interdisciplinary team of licensed and unlicensed care givers who ensure that patients, families and significant others receive individualized high quality, safe patient care. They practice in a clinical environment that is administered by Nurse Supervisors/ Office Managers and other leaders and is supported through the WellStar Clinical Champion Forum. The framework for practice is steered by the WellStar Professional Practice Model, 5-Star Nursing and evidence based practice and research. RN competencies are derived from these models and supported by the WellStar Core Competencies.It is expected that all RN Clinical Nurses are licensed, knowledgeable and uphold the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association. As a member, of the patient services team, it is expected that the individual upholds the voice of the patient, system policies and procedures while supporting service excellence goals.ResponsibilitiesCore Responsibilites and Essential Functions Exemplary Practice and Outcomes* Performs the Nursing Process (assessment; diagnosis; identification of outcomes; planning; implementation and evaluation) in the performance of clinical care using evidence base practice, uses analytical/critical thinking and ensuring that care is individualized; coordinating care through effective partnerships recognizing that caring is central to achieve optimal patient care outcomes* Provides relationship-based patient centered care that is consistent with population specific characteristics (e.g. age, gender, disease, etc) in a manner that adapts service delivery to reflect an understanding of cultural diversity* Always partners with the patient and significant others (as appropriate) using such appropriate method for setting and purpose (e.g., bedside shift report; interdisciplinary rounds; just in time and planned patient teaching; keeping the patient and significant others updated and making the patient's goals the focus of the plan of care.* Practices using current clinical practice standards. Teamwork and Collaboration* Coordinates the delivery and documentation of safe quality patient care that promotes the professional care delivery model. This includes, but is not limited to diverse and inclusive interdisciplinary communication methods (interdisciplinary rounds, case review, etc); completion of timely documentation and promotion of a respectful, inclusive clinical environment* Demonstrates teamwork and collaboration by practicing in a manner that is fiscally responsible and promotes the recruitment and retention of all healthcare team members.* Participates and supports performance improvement inclusive of all stakeholders, research and research utilization to promote safe, quality patient care including initiating and/or leading such activities as well as, promoting an inter/intra-disciplinary process and actively supports/participates in Clinical Champion Forum at the Medical Group level. . Professional Development and Initiative* Completes all initial and ongoing professional competency assessment, required mandatory education, population specific education.* Serves as a preceptor and/or or mentor for other professional nurses (and staff or students for all disciplines) to ensure that there is a current and future qualified workforce; modeling the professional practice of nursing and creating a healthy work environment Evidence Based Practice and Research * Promotes Evidence based practice, nursing research and performance improvement in nursing. Participates in activities such as value analysis as part of the decision-making process in evaluating patient care products.* Upholds all health care system/organizational policies and procedures and clinical competencies put forth by this job description and professional association including legal, regulatory and accreditation requirements and standards ensuring by way of example, such goals as TJC Patient Safety Goals and Wellstar Health Systems' safety absolutes * Participates in data collection, poses relevant clinical questions to advanced evidence-based practice. Consults appropriate experts and uses appropriate resources and evidence to address practice questions. Resources and Support * Proactively plans for the care of patients across the care continuum in the course of giving direct patient care. * Participates in the development of protocols and procedures when called upon or through self-initiation in collaboration with care managers and other members of the health care team to achieve best practice outcomes (i.e., decrease in re-admission rates; avoidable days; adverse events; etc).* Supports efficient and effective use of human and material resources. Required for All Jobs Performs other duties as assigned Complies with all WellStar Health System policies, standards of work, and code of conduct. QualificationsRequired Minimum Education Graduate of an accredited/approved school of nursing Required and Baccalaureate degree in nursing (BSN) from an accredited school of nursing Preferred and National certification in area of specialty preferred Preferred Required Minimum Experience Experience with direct patient care. Preferred Additional specialty experience may be required. Required Minimum Skills Ability to read, write and speak English language, optimize the use of technology to support clinical care and holds basic computer skills Strong interpersonal, collaborative skills along with customer service skills required Ability to function in a fast-paced environment and respond to emergencies in using a decisive, composed and respectful manner Possess excellent time management skills: practices nursing using evidence and analytical skills along with possessing strong critical thinking skills Required Minimum License(s) and Certification(s)Reg Nurse (Single State) Required RN - Multi-state Compact Required Basic Life Support Required BLS - Instructor Required BLS - Provisional Required Additional Licenses and Certifications Current/active license as a registered nurse in the State of Georgia Required Must have a current BLS card from the American Heart Association, prior to hire date. Required ACLS/PALS may be required in some practice areas. Share the opportunity Mission, Vision & Values At a time when the healthcare industry is changing rapidly, Wellstar remains committed to exceeding patients' and team members' expectations, while transforming healthcare delivery.Our Mission To enhance the health and well-being of every person we serve.Our Vision Deliver worldclass health care to every person, every time.Our Values We serve with compassion We pursue excellence We honor every voice

Overview The Clinical Documentation Auditor is a proactive member of an interdisciplinary team of licensed and unlicensed care givers who ensure that patients, families and significant others receive individualized high quality, safe patient care. It is expected that all RN Clinical Nurses - are licensed, knowledgeable and uphold the practice of nursing as outlined by the Georgia Professional Nurse Practice Act and implements the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association. Schedule:Full Time Shift: Shift Level: 6+ years of experience Success Profile Find out what it takes to succeed as a Clinical Documentation Auditor: Collaborative Time Efficient Organized Critical Thinker Attention to Detail Compassionate Benefits that Reflect Your Contributions Your Pay A compensation program designed for fair and equitable pay. Your Future Secure your future with plans that also include an employer match. Plans and guidance for the future. Your Wellness Traditional healthcare benefits combined with progressive wellness programs to help you be your best self!. Your Joy Special and unique benefits and programs ensuring a balanced life and a workplace culture built on trust. Job Details Facility: VIRTUAL-GAJob Summary: The Clinical Documentation Integrity Lead demonstrates excellent clinical proficiency and critical thinking skills necessary to support and improve the overall quality and completeness of clinical documentation in the patient medical record. Assists the CDI leadership team in creating a support structure within the department for achieving clinical and operational excellence in relation to Clinical Documentation Integrity efforts. Collaborates with clinical and non-clinical team members at Wellstar facilities to achieve department goals in relation to Clinical Documentation Integrity efforts, as well as interdisciplinary teams including, but not limited to, physicians, nurse practitioners, PA's, and the department representatives for Revenue, Coding, Care Coordination and Health Information Management. Plays key role in determining metric measurements that are meaningful to the CDI department and will assist in analyzing, tracking, trending, and reporting CDI and/or organizational data and metrics at both system and individual facility-level. Presents the results of studies, trends, and activities as necessary to demonstrate solution performance and improvement in clinical documentation. Assumes responsibility for professional development through participation in workshops, conferences and/or in-services and maintains appropriate records of participation. Works collaboratively with team members to provide data and solution development processes. Demonstrates ability to assist in process and workflow improvements, system technology implementations and project management. Provides ongoing Clinical Documentation Integrity program education for new team members, including but not limited to, Clinical Documentation Specialists, physicians, nurses and allied health professionals. Core Responsibilities and Essential Functions: Specializes in 1) CDI Specialist Onboarding Education, 2) In collaboration with physician partners, ensures physician education, or 3) Performs Audits. Assists management remotely with preparing provider education materials, gathering articles or other information for presentations and meetings. Performs staff, PSI, HAC, HAI, mortality, etc. reviews remotely as assigned by management. a)Initiates gathering topics, preparing and providing regular CDI education to team members based on trends, industry events and based on management needs b)Conducts new specialist onboarding and education c)Reviews medical records concurrent to the patient stay to determine opportunities as it relates to clinical documentation improvement, PSI, HACs, mortality, etc. d)Conducts and provide real-time audits of reviews, queries and reports and provide feedback on process, query opportunities and query compliance. Reviews data and trends to identify additional areas of opportunity. e)Conducts Validation and Special Project tasks to support the CDI Manager/Director and ensure appropriate data is entered, captured and reported in the CDI Software for the accuracy and completeness of clinical information used for measuring and reporting physician and hospital outcomes. f)Functions as a Super User with CDI Software and all other applications utilized in this position. g)Assists with payroll as it relates to timekeeping duties as assigned by management Reviews clinical documentation remotely during patient admissions to determine opportunities to improve physician documentation and communicates identified opportunities to the physician. a)Reviews medical records to determine opportunities to query physicians regarding clinical documentation b)Conducts follow-up reviews to ensure appropriate clinical documentation is recorded in patient's chart. c)Performs hospital-wide medical record reviews facilitating improvement in the quality, completeness and accuracy of medical record documentation to ensure coding compliance, accurate reporting, and improved patient outcomes. d)Submits electronic queries as appropriate, to clinicians to ensure documentation of complete and accurate records to allow coding assignments post discharge that will accurately reflect the severity and risk of mortality of the patient population. e)Ensure queries are compliant, grammatically correct, concise and free of typographical errors. f)Provides appropriate follow up on all queries. g)Notifies CDI Manager immediately when queries are not answered. Provides all data necessary for onsite Regional CDI Manager to assist. h)Reconciles all appropriate records daily in CDI software tool to ensure appropriate reporting is generated. i)Maintains required daily/weekly/monthly metrics. Meets productivity standards. j)Participates in required onsite meetings, conference calls and Skype presentations. k)Adheres to departmental Policies and Procedures. l)Participates in assuring hospital compliance with Federal and State regulatory requirements. m)Submit ideas to improve work flow and increase productivity of his/her team to the CDI Leadership team and perform any other duties as assigned. Maintains knowledge of coding and billing rules and regulations to ensure that the documentation in the medical record supports appropriate reimbursement. a)Participates in assuring hospital compliance with Federal and State regulatory requirements. b)Reviews quarterly Coding Clinic changes/summaries and follows appropriate required changes to their process. Required Minimum Education: Associate's Degree in nursing Required or Diploma from an accredited nursing program Required or Bachelor's Degree in a healthcare-related program Required or Doctorate Completed degree from an accredited medical school Required Required Minimum License(s) and Certification(s): All certifications are required upon hire unless otherwise stated.Cert Clin Document Specialist within 180 Days or Cert Document Improvement Prac within 180 DaysReg Nurse (Single State)-Preferred or RN - Multi-state Compact-Preferred or Cert Coding Spec-Preferred or Cert Prof Coder-Preferred or Reg Health Information Admin-Preferred or Reg Health Information Tech-PreferredAdditional License(s) and Certification(s): It is expected that all RNs are licensed, knowledgeable and uphold the practice of nursing as outlined by the Scope of Practice and Code of Ethics Standards put forth by the American Nurses Association Upon Hire Required or It is expected that all non-clinical (coding) background candidates have at least one of the following active/current certifications: (1) Certified Coding Specialist (CCS) from AHIMA, (2) Certified Professional Coder (CPC) from AAPC, (3) Registered Health Information Administrator (RHIA) from AHIMA, or (4) Registered Health Information Technician (RHIT) from AHIMA Upon Hire Required Required Minimum Experience: Minimum 2 years working in an acute care setting as a Clinical Documentation Specialist (CDS) Required and Minimum 5 years healthcare experience Required and Prior experience of working as a CDI/Coding auditor is preferred Preferred and Prior experience of working in inpatient case management or utilization review is preferred Preferred and Required Minimum Skills: Strong understanding of disease processes, clinical indications and treatments; and provider documentation requirements to reflect severity of illness, risk of mortality and support the diagnosis/procedures performed for accurate clinical coding and billing according to the rules of Medicare, Medicaid, and commercial payors Familiarity with encoder and current working knowledge of Coding Clinic Guidelines and federal updates to DRG system (MS and APR) Epic and 3M360 experience is preferred Expert knowledge/experience in managing all aspects of Clinical Documentation Integrity, including CDI productivity, quality, education and training, compliance auditing, data analysis and trending, report management, performance improvement initiatives Chart review experience required. Excellent communication skills, employing tact and effectiveness Demonstrate effective communication skills and collaborates with medical staff, clinical departments, and key facility leadership team members Ability to interpret, adapt, and apply guidelines, procedures, and continuous quality improvement initiatives Excellent problem-solving skills, with the ability to recommend and implement practical and efficient solutions Must have proficient computer skills in Microsoft Apps, such as Word, Excel and PowerPoint, as well as CDI technology tools required for the job functions Must be comfortable with doing data analysis, and preparing and maintaining records and written reports Drives optimal use of the CDI technology tool and reporting capabilities Excellent time management, training and peer development skills Share the opportunity Mission, Vision & Values At a time when the healthcare industry is changing rapidly, Wellstar remains committed to exceeding patients' and team members' expectations, while transforming healthcare delivery.Our Mission To enhance the health and well-being of every person we serve.Our Vision Deliver worldclass health care to every person, every time.Our Values We serve with compassion We pursue excellence We honor every voice

Description Nurse Care Manager ll (2:30pm - 11am Eastern Time) JR114007 Work Hours : 2pm - 11pm Eastern Time, Monday - Friday. Location: Must reside within 50 miles / 1 hour commute of an Elevance Health Main Office / PulsePoint. Atlanta, Georgia area strongly preferred. The Nurse Care Manager ll is responsible for collaborating with healthcare providers and members to drive personalized health management and improve health outcomes for optimal consumers. Performs assessments and care management activities telephonically within the scope of licensure for members with complex and chronic care needs. Primary duties may include, but are not limited to: Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, out of network services, and appropriateness of treatment setting and level of care. Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance. Collaborates with providers to assess consumer needs for early identification of and proactive planning for discharge. Conducts clinical assessment to develop goals that address individual needs in order to develop a care plan; implements and coordinates a care plan. Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Assists with development of utilization/care management policies and procedures. Participates in or leads intradepartmental teams, projects, and initiatives. Minimum Requirements: Minimum of 3 years of acute care clinical experience, condition specific clinical experience, home health/discharge planning experience and a minimum of 1 year in a Nurse Care Mgr I role or equivalent experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in the state of residence required. Multi-state licensure will be required. Preferred Qualifications: AS or BS in nursing preferred. Multi-state or Compact license, or additional individual state RN licenses a plus. Clinical Experience in Med/Surg, Critical Care, ER, internal medicine a plus. Call center or telephonic environment a plus. Patient assessment and education preferred. Certification as a Case Manager is preferred. Prior managed care experience preferred. Knowledge of medical management process and ability to interpret and apply member contracts, member benefits, and managed care products strongly preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance.