Ascension Health RN Access Care Manager in Kalamazoo, Michigan

Job ID: 269826

RN Access Care Manager

Kalamazoo, Michigan

Regular/Day

Additional Job Information

Title: RN Access Care Manager

City, State: Kalamazoo, MI

Location: Borgess Medical Center

Department: Case Management 002

Additional Job Details: Full-Time Day, 40 Hours Weekly

About Us

Based in Kalamazoo, Borgess provides care for nearly 1 million people annually in cardiac, neurologic, orthopedic, vascular and bariatric services, among others. We are one of the region’s largest health systems and employers and have been serving as part of Ascension since 1999.

Job Description

Job Summary:

The RN Access Care Manager provides health care services regarding admissions, case management, discharge planning and utilization review.

Responsibilities:

  • Reviews admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity and/or compliance with reimbursement policy criteria. Provides case management and/or consultation for complex cases.

  • Assists departmental staff with issues related to coding, medical records/documentation, precertification, reimbursement and claim denials/appeals.

  • Assesses and coordinates discharge planning needs with healthcare team members.

  • Prepares statistical analysis and utilization review reports as necessary.

  • Serves as lead to the Medical Staff and BH for the Care Management Program.

  • The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

Qualifications

Licenses/Certifications/Registration:

  • Required Credential(s):

  • Licensed Registered Nurse obtained prior to hire date or job transfer date.

Education:

  • Bachelor's Degree in a health-related field required or must be completed within one (1) year of start date.

Work Experience:

  • Minimum of two (2) years clinical experience in any setting required. One (1) year experience in an acute care setting preferred.

  • Recent or current knowledge and experience related to utilization management theory and practice preferred.

  • Basic computer skills in word processing and spreadsheet software, and experience with the electronic patientrecord and MIDAS preferred.

How To Apply

If you are interested in joining us, click here https://ascension.ttcportals.com/jobs/search/ to search for a job and complete an online application.

We urge you to apply for any/all positions in which you are interested. If you fit the qualifications for the role, we will reach out to you. Please ensure you complete all required fields within the application (indicated with an asterisk), as well as, additional information that is requested of you. Information that you offer us will better assist us in understanding your qualifications and fit for the position(s) for which you've applied.

Equal Employment Opportunity

Borgess Health is an equal opportunity employer, dedicated to the nondiscrimination in employment on the basis of race, color, age, religion, sex, national origin, handicap, disability, veteran or marital status.

Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.