Clinical Case Manager – Case Management / Finance Revenue Cycle

JOB SUMMARY

Under the supervision of System Manager of Case Management, this position conducts admission, concurrent and retrospective case reviews in the clinical setting to determine the appropriate level of care and clinical setting necessary to provide for the care of the patient. Performs other duties as assigned.

 

MINIMUM QUALIFICATIONS

  • Must be licensed as a Registered Professional Nurse in the State of Illinois. (Must provide license at time of interview)
  • One (1) year of full-time work experience in utilization management or case management is required.
  • Two (2) years of full-time work experience in acute care nursing is required.
  • Knowledge of Medicare, Medicaid and Third Party Payer review requirements is required.
  • Knowledge of InterQual and / or Milliman criteria sets is required.
  • Graduation from an accredited school of Nursing with a Bachelor’s degree is preferred.
  • Credentialed as an Accredited Case Manager (ACM) or Certified Case Manager (CCM) is preferred.
  • Knowledge of ICD-9 Coding with ability to assign admission diagnosis codes is preferred.

KNOWLEDGE, SKILLS AND ABILITIES

Knowledge of: hospital and physician coding and documentation practices; Federal, State, Local and Agency health-care laws, standards and financial regulations, Medicare, Medicaid and Third Party Payer review requirements, as well as InterQual and/or Milliman criteria sets and Skilled in: written and verbal communication; conflict management and decision making; ICD-9 Coding with the ability to assign admission diagnosis codes; and Microsoft Office and electronic medical records software. Ability to: demonstrate sensitivity and respect in caring for patients: adhere to and support the mission, ethics and goals of the health system.

 

MUST MEET ALL REQUIRED QUALIFICATIONS AT TIME OF APPLICATION FILING.

 

Degrees and transcripts from non-U.S. accredited institutions must be translated and certified to the U.S. equivalent academic credentials by a recognized U.S. education interpreter service.

 

COOK COUNTY GOVERNMENT IS AN EQUAL OPPORTUNITY EMPLOYER.


Requisition ID: 00115089

Post Date: August 5, 2014

Closing Date: August 19, 2014

Salary: $30.36 Hourly

Location: John H. Stroger, Jr. Hospital of Cook County

Visibility: External

This position is no longer available.