RN- Denials/Charge Audits, Full Time, First Shift

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At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is committed to providing an inclusive, equitable and diverse place of employment. Under the supervision of the Director of Quality Management and Informatics, provides support for data analysis, data mining, and quality monitoring and support improvements in quality of care, service levels, revenue realization and cost effectiveness. - Minimum Required: Associate degree - RN. - Other: Diploma Nurse. - Preferred: Bachelor's Degree - RN. - LICENSE & CERTIFICATION: Registered Nurse. - Minimum Required: 1 - 2 Years equivalent experience. Preferred: 3 - 5 Years equivalent experience. - Experience using insurance platforms/portals: Availity, UHC/Optum, PNM (OH Medicaid), etc. - Remote work environment experience - Epic knowledge and experience are a must PATIENT POPULATION - (CLINICAL ONLY): - Engages in population appropriate communication. - Has knowledge of growth and development milestones and tasks. - Gives clear instructions to patients/family regarding treatment. - Involves family/guardian in the assessment, initial treatment and continuing care of the patient. - Identifies any physical limitations of the patient and deploys intervention when necessary. - Recognizes and responds appropriately to patients/families with behavioral health problems. - Interprets population related data and plans care appropriately. - Identifies and responds appropriately to different needs resulting from, unique psychological needs or those associated with religious / cultural norms. Performs treatments, administers medication or operates equipment safely. - Recognizes and responds to signs/symptoms of abuse or neglect. - Performs reviews of patient records for completion of TJC core measure cases. Enters data into Midas system. Prepares reports and other documentation to improve the processes of care. Works with hospital PI committees responsible for improving these processes. - Performs reviews of patient records to monitor for quality outcomes using population-specific clinical database based on established indicators. Enters all utilization and quality data into the database system as outlined in procedures. Responsible for transmission of data to appropriate registry on a routine basis. - Identify actual and potential delays in service or treatment and opportunities for improvement (OFI) and refer to the appropriate individuals within the multidisciplinary patient care teams. Receives comparative reports from registry and handles all necessary correspondence and communication with the registry. - Identifies appropriate data to be collected and assists in formulation of strategies for performance improvements including complications, adverse outcomes, etc. Participates in process improvement teams as developed for this project. - Serves as a consistent resource regarding project specific quality information and trends. Participates in project related organization wide activities in order to coordinate data analysis efforts. Maintains knowledge of current trends and developments in the field. --- _This job was found on [bandana.com](

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

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Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

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Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

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9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...