Registered Nurse (RN) Care Coordination
Company: Saint Peter's Healthcare System
Location: New Brunswick
Posted on: May 3, 2021
Coordinationgroupat Saint Peter's is seeking a Registered
Nurse to join their team. The Care Coordination Nurse
performs admission and concurrent review of patients. Provides
clinical information to payors. Initiates appropriate referrals to
Physician Advisor. Active intervention as needed to reduce denials.
Collaborates with other disciplines to implement a care plan.
Coordinates home care plan and referrals for patient. Supports the
collection of quality and risk management data.
theCare CoordinationNurse, you will:
appropriate medical information necessary to certify/refer cases on
admission and on continued stay review
- Performs assigned admission
reviews within established time frame (within 24 working hours of
admission) with concurrent daily reviews for managed care
companies, and one to three days for concurrent review for other
assigned payer categories as evidenced by no denials for lack of
- Ensures timely
provision of clinical review information to payer as evidenced by
no denials for lack of clinical information.
- Initiates provision of review
to payer independent of payer request unless there is lack of clarity
regarding the product and to whom review should
possible, manages request for concurrent reconsiderations as
evidenced by the "Overturn" of the initial denial
collaboration with the Medical Staff by requesting additional
clinical information and/or suggestions for documentation so as to
obtain payer determination of "acute" for each inpatient day as
evidenced by the Net Denial Rate.
the interdisciplinary team and the development of the plan of
comprehensive, realistic and achievable home care plan as
appropriateto the ages of
the patients and to the developmental life cycle stage.
nurse currently licensed to practice in the state of New Jersey
of three (3) to five (5) years experience in acute care nursing.
Experience should include assessment of a patient's diagnosis,
prognosis, care needs and outcomes goals. The ability to analyze
medical records including clinical and laboratory data and problem
solving skills are required.
good interpersonal and communication skills.
be willing to work on some weekend days and on some holiday
Job Posted by ApplicantPro
Keywords: Saint Peter's Healthcare System, New Brunswick , Registered Nurse (RN) Care Coordination, Other , New Brunswick, New Jersey
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