EDUCATION Bachelor of Science in Nursing is required. Familiarity using a personal computer including word processing and spreadsheets is required. Knowledge of reimbursement models (commercial, managed care, Medicare) is preferred.
PRIOR EXPERIENCE Three to five years experience as a clinical nurse in an acute care setting. Prior experience in a hospital or office type setting preferred, prior experience as a Case Manager. Knowledge of MS Office Suite required. Insurance/payer experience preferred/prior utilization review experience preferred. Proficiency in Allscripts, MCG and InterQual preferred.
ON THE JOB EXPERIENCE Approximately six months to gain familiarity with the hospital environment, department routines and procedures and full range of duties.
PROBLEM SOLVING Ability to establish priorities, meet deadlines and maintain standards of productivity.
INTERNAL CONTACTS Internal contacts necessary to effectively advise, consult or counsel others to gain cooperation and acceptance of ideas or actions.
INDEPENDENT JUDGEMENT Work assignments are generally received in the form of results expected, due dates, and general approach to be taken. Ability to incorporate clinical skills, theoretic concepts and knowledge of costs in determining effective and appropriate course of action.
PATIENT CARE Assists with patient care by establishing and/or monitoring the techniques, policies, and procedures used by those who deliver care; and by assisting in the coordination of patient care planning and discharge plans.
RESPONSIBILITY FOR WORK OF OTHERS Not responsible for supervising others.
CERTIFICATION/REGISTRATION/LICENSURE Licensure as a registered nurse in the District of Columbia is required.