RN Case Manager - Perioperative Services

Silver Spring, Maryland
Oct 10, 2021
Nov 09, 2021
Full Time
Employment Type:

Full time


Day Shift


Position Highlights:
  • Competitive pay
  • Additional Benefits: Relocation assistance, tuition reimbursement, free parking
  • Quality of Life:Flexible work schedules
  • Advancement:Opportunities to advance through the Clinical Advancement Program
  • Location:Holy Cross Health has two hospitals and four healthcare centers all a short driving distance from Washington DC and Baltimore, MD

General Summary:

This position is primarily responsible for ensuring compliance with regulatory guidelines related to designation (inpatient v. extended outpatient services) for surgical patients. This function includes but is not limited to:
  • Cross checking the surgeon's original patient designation status to patient registration and insurance authorization prior to surgery.
  • Cross referencing CPT codes to CMS inpatient status list prior to surgery,
  • Review of surgical procedure with cross reference to utilization review criteria postoperative to ensure appropriate postoperative status.
  • Facilitating patient designation changes and correction as needed.

The incumbent works closely with physicians, nurses and admission and registration staff to facilitate appropriate designations. Serves as a resource to all internal customers. Works with a high degree of autonomy.

Supports the Mission of Trinity Health and Holy Cross Hospital.

Minimum Licensure/Certification Required (if applicable):

RN licensed in the state of Maryland

Minimum Knowledge, Skills, and Abilities Required:

Bachelor's Degree preferred. Certification in Case Management preferred.

At least three years acute care experience required; Utilization/Quality Management, Discharge Planning and/or Clinical Documentation enhancement experience preferred.

Knowledge of overall hospital operations, especially in areas of reimbursement and regulatory matters.

Surgical Nursing background preferred.

Knowledge of ICD.10 and CPT coding preferred

Highly articulate with strong written and verbal communication skills.

Computer literacy and analytic skills required.

Able to communicate effectively.

Demonstrated ability to work with all age groups of patients (birth to geriatric).

Ability to be handle sensitive issues with poise and tact.

Patient assessment skills required.

Mastery of CMS criteria for observation status.

Preferred bilingual with English and Spanish proficiency.

About us:

Holy Cross Health is a Catholic, not-for-profit health system that serves more than 240,000 individuals each year from Maryland's two largest counties - Montgomery and Prince George's counties. Holy Cross Health earns numerous national awards, clinical designations and accreditations across a wide range of specialties for providing innovative, high-quality health care services.

Holy Cross Hospital has received the award and achievement of being one of Healthgrades 2021 America's 100 Best Hospitals.

Holy Cross Health is an Equal Employment Opportunity (EEO) employer.

Qualified applicants are considered for employment without regard toMinority/Females/disabled/Veteran(M/F/D/V) status.


Trinity Health's Commitment to Diversity and Inclusion

Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

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