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Award-winning: Sentara is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering more than 500 sites of care including 12 hospitals, PACE (Elder Care), home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!
Sentara Health is hiring an Observation Clinical Analyst, Registered Nurse for the Health Information Management Department.
This is a Full-time, REMOTE, 40 hours per week, 8 hours per day, Day shift position.
Review of physician orders for medical necessity, appropriateness based on Payor guidelines, and applying charges for Observation hours.
Responsible and accountable for the provision and facilitation of comprehensive care coordination services and quality outcomes for patients across the continuum. Promotes effective utilization and monitoring of health services, collaborates and communicates with the healthcare team and patient/caregiver to manage care and transitions. Develops and/or implements a comprehensive care plan based on assessment and evaluation of patient/caregiver needs. Functions in one of the following practice settings: Acute Care, Service Lines, Ambulatory/Community-based, Home Health, and Long Term Care.
Education
- Registered Nursing Diploma
Certification/Licensure
- Valid RN license
- For Integrated Care Management departments, specialty certification required within one year of eligibility (ACM, CCM, CCCTM, CMAC or CGMT-BC). For other service lines, certification based on specialty area required within one year of eligibility.
Experience
- Three years Registered Nursing experience required.
- Epic EMR experience preferred.
Keywords: Talroo-Health Plan, Talroo-Nursing, Monster, LinkedIn, billing, medical necessity, audit, observation hours, payor guidelines, CCM, ACM, CCCTM, CMAC, Epic, charges, chart review, revenue cycle, patient billing, utilization review
Culture In Action
At Sentara, our differences are our strengths. The unique backgrounds, skills, and experiences that each Sentara colleague brings to work are what make Sentara special and what allows us to deliver excellent service and care to our patients, members, and communities.
Sentara prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
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