At MemorialCare Health System, we believe in providing extraordinary health care to our communities and an exceptional working environment for our people. Whether it's our recognition as one of the nation's Top 100 Health Systems or outcomes that repeatedly exceed the expected, you'll be energized by our commitment to innovation, continuous learning and your professional and personal growth.
The RN Revenue Cycle Care Manager ensures appropriate financial recovery through reconciliation of authorizations and timely processing of appeals in collaboration with care managers, third party payers, and business office, and quarterly reporting of avoidable days, potentially avoidable (PAD’s) denial trends and opportunities to UR staff committee. Additionally this position provides relief care manager coverage as assigned by leadership. The RN Revenue Cycle Care Manager collaborates with other professional disciplines/unit leaders to ensure safe and effective patient care delivery and the achievement of desired patient outcomes. This position is responsible for facilitation of appropriate length of stay and continuum of care outcomes, through the case management of all systems and services required for an organized, multidisciplinary team approach to care. The Case manager coordinates patient’s care from admission, hospitalization, to discharge follow-up in
collaboration with the healthcare team, to best meet the patients’ physical, emotional, and spiritual needs. The RN Revenue Cycle Care Manager uses a problem-solving process that includes assessment, problem identification, goal definition, plan development, evaluation, reassessment, and plan revision, and documentation in the patient record to achieve optimum patient outcomes on both an individual and population basis.