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Decypher is a leading integrator of professional, technology, and management solutions and services. We provide our services globally to Federal, Commercial, Local, and State clients. Our employees are our most valuable asset and play an integral role in the success of Decypher and our clients. Working at Decypher is not just a job, but a career where your talent and energy are respected, and you can make a difference. Decypher invites you to join our professional team.
Minimum Qualifications:
* Degree: Associates Degree of Nursing.
* Education: Graduate from an accredited college or university by ACEN, CCNE, or as outlined in the TO.
* Certification: Possess one of the following certifications: CDMS, CRRN, COHN, COHN-S, ACCC, CRC, RN-NCM, or CMC.
* Experience: Minimum of two (2) years recent experience in professional nursing within the last four (4) years. Experience in Case Management (CM) or Utilization Management (UM) is required, with specific experience in clinical review, coding, and medical necessity justification.
* Licensure: Current, active, and unrestricted RN license, allowing independent practice.
This job description is not all-inclusive. Employees may be asked to perform other duties as assigned by management.
Required Skills/Abilities
* Participate in all phases of the Case Management Program (CMP), ensuring standards are met.
* Provide nursing expertise in assessment, planning, implementation, coordination, and monitoring of case management.
* Develop and implement strategies and tools for case management, including patient identification, assessment, guidelines, algorithms, and databases.
* Integrate case management with utilization management and social work case management.
* Maintain liaison with community agencies and organizations.
* Accurately document patient care data.
* Develop and implement treatment plans for continuity of care.
* Ensure proper implementation and follow-up of treatment plans post-discharge.
* Provide health care instruction to patients and caregivers based on learning needs.
Decypher is committed to equal opportunity employment, fostering an inclusive environment. This position is not authorized for remote/telework.
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