Posted in Other 30+ days ago.
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Type: Full Time
Truman Medical Centers, a two-hospital, 600-bed, not-for-profit healthcare system, is the largest and most comprehensive safety net healthcare provider in Jackson County and Kansas City, Mo. TMC serves as the pri mary teaching hospital for the University of Missouri-Kansas City Schools of Medicine, Nursing, Dentistry and Pharmacy.
Our Hospital Hill campus is located in the UMKC Health Sciences District: a premier academic health district engaging in cutting-edge biomedical research and entrepreneurship, delivering state-of-the science health care, and educating the next generation of health care professionals. Recognized as a critical area resource for advanced specialized healthcare, TMC is constantly working to deliver the best pos sible medical care for our patients. Quality, innovation, team work and attention to detail are at the heart of all we do. TMC s tagline is: Better. For Everyone. It is a simple statement, but it has profound significance. It is what we stand for, it is the focus of our work, and it is our promise to our patients.
The Outpatient Oncology Utilization Nurse is a member of the Oncology Clinic working closely with the Patient Accounts department. This position will utilize clinical skills to assist in the facilitation of prior authorizations of clinical procedures and treatment regimens, as well as provide support with medical necessity reviews in the management of denials. This person will work collaboratively with internal and external stakeholders to assess workflow processes, identify insufficiencies, and investigate root causes and work to implement change to ensure timely certifications. Understands the business of the department and how the work impacts the overall revenue cycle. Recognizes out of the ordinary situations and works with stakeholders to improve processes. Assignment of additional duties and responsibilities can be made as defined by, and at the discretion of the Department Manager and/or Director of Hematology/Oncology Clinic.
Knowledge, Skills, and Abilities
* Current Missouri License as a Licensed Practical Nurse or Registered Nurse
* Excellent written and verbal communication skills
* Minimum of three (3) years experience working in a healthcare setting
* Experience with insurance prior authorizations and medical necessity criteria for various payers
* Proficient in Microsoft Word and Excel
* Experience with electronic medical records and insurance programs (Preferably Cerner)
* Must be able to read and speak the English language
* Experience with Oncology treatment plans
* Experience in a business office setting
* Familiarity with high tech Radiology and/or Cardiology procedures beneficial
8:00AM - 4:30PM
Truman Medical Centers is committed to being a leader in providing culturally inclusive health care services for patients in ways that are effective, fair, respectful, and culturally competent and in providing a culturally inclusive workplace for employees. We value and celebrate our differences, which include, but are not limited to, race, ethnicity, language, national origin, age, socioeconomic status, literacy, gender identity and expression, sexual orientation, mobility, abilities, and belief systems.