Quality Nurse- CDI/Denials (Registered Nurse)

Department:Quality ImprovementEmployment StatusFull-Time (1.0)- 80 Hours Per Pay PeriodBenefit Status: Full TimeBenefits includeHealth, Dental, and Vision InsuranceEmployee Health Clinic (health +): Our health+ clinic provides office visits and prescription medications for little to no cost to Alomere Health employees and their dependents who are on a medical insurance planRetirement Savings: (401(k)) - All eligible employees of Alomere Health are automatically enrolled. All eligible employees are able to contribute on a pre-tax and/or post-tax basis and Alomere Health matches 100% up to 6% of employee's contributions.Please see more details about our benefits here: alomerehealth.com/careersHours:Monday thru Friday: 7:30am- 4:00 pmRequires Onsite hoursPosition ObjectiveThe Quality Nurse shall be under the general supervision of the Supervisor of Quality. This position performs essential duties related to Quality and specialty programs such as Clinical Documentation (CDI) and Utilization Review (UR). The Quality Nurse will assist with education, data abstraction, ACHC Standard review, Quality of Care reviews, Payer appeals, complaints and other duties as assignedEssential ResponsibilitiesFunctional LeadershipInteract closely with Physicians for Clinical Documentation Integrity and Utilization ReviewComplete full CDI training with ability to share lead CDI Nurse dutiesLearn elements of the UR Program with ability to review and assist as neededAbility to work independently as well as with other members of the Quality TeamCommunication and ReportingComply with confidentiality of the medical recordsCollaborate with the Quality Supervisor, Director of Quality & Risk Management, Physicians and other members of the healthcare teamAbility to speak directly to physicians, providers and staff on quality-related projects or concernsAssist in quality (Abstracting), Clinical Documentation Improvement (CDI) and case reviews for overall quality improvementAssist with patient concerns under the direction of the Department DirectorOther ResponsibilitiesPerform all other related duties as assigned in a professional and responsive mannerDemonstrate the ability to use relevant equipmentSupport, understand, and promote Alomere Health's mission, vision, values, policies and proceduresAbility to meet the work schedule requirements with flexibility depending upon the needs of the departmentFoster respectful working relationships with professional colleagues, patients, families, and general public regardless of age, gender, lifestyle, culture, beliefs, race, socioeconomic class, or abilityRequired QualificationsGraduate of an accredited RN ProgramMinimum of two years' experience in an acute care hospital and patient care practiceActive and current RN registration/licensure in the state of MinnesotaPreferred QualificationsExperience or training in Quality, or Quality-related trainingKnowledge, Skills and AbilitiesKnowledge of EPIC, Microsoft Office and other software applicationsUnion Position: