Payment Integrity Program Manager Jobs in Monticello, IA

Employment Type:Part timeShift:12 Hour Day ShiftDescription:At MercyOne, health care is more than just a doctor's visit or a place to go when you're in need of medical attention. Our Mission is based on improving the health of our communities - that means not only when you are sick but keeping you well.
MercyOne Central Iowa sets the standard for personalized and radically convenient care in the Des Moines metro area and surrounding counties. MercyOne Des Moines Medical Center, founded by the Sisters of Mercy in 1893, is the longest continually operating hospital in Des Moines and Iowa's largest medical center, with 802 beds available. The hospital is one of the Midwest's largest referral centers.
With more than 7,000 colleagues and a medical staff of almost 1,500 physicians and allied health professionals, MercyOne Central Iowa is one of Iowa's largest employers.
MercyOne Dyersville Senior Care
MercyOne Dyersville Senior Care is a 40-bed senior care facility providing the highest quality care to your loved ones when they need it most. We offer residents a full range of services in a personal, home-like setting to meet physical, emotional, social and spiritual needs. Residents are often at a higher risk when flu, Covid-19 and other respiratory illnesses are spreading in the community. Please refrain from visiting if you are sick.
Our facility adjoins MercyOne Dyersville Medical Center, so you can take comfort in knowing your loved one will be taken care of, even in an emergency. In addition to immediate access to medical care, we offer the following long-term care services:
Services
Professional nursing care 24/7
Emergency department, family practice and pharmacy on-site
Medicare Part B rehabilitation program
Healthy meals and registered dietitians to monitor nutritional needs
Social worker to provide counseling, guidance, and emotional support

Want to learn more about MercyOne Dyersville Senior Care? Click here: MercyOne Dyersville Senior Care | MercyOne

Join the MercyOne Family! We are looking to hire a Long term Care RN for our MercyOne Dyersville Senior Care

As the Long term Care RN at MercyOne, you will:

• The RN supervises and coordinates care provided to residents by the LPN, Certified Nursing Assistants and other nursing team members.
• The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.
• The nurse's primary commitment is to the resident, whether an individual, family, group, or community.
• The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the resident.
• The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum resident care.
• The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.
• The nurse participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action.
• The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.
• The nurse collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.
• The profession of nursing, as represented by associations and their members, is responsible for articulating nursing values for maintaining the integrity of the profession and its practice, and for shaping social policy.

Schedule:

• PRN
• Days and Nights

General Requirements:

• Adheres to the principles of caring and expected behaviors outlined in MercyOne Dubuque/Dyersville Medical Center's Model of Caring and Trinity Health's Code of Conduct, fostering a climate where all customers are treated in a manner consistent with MercyOne Dubuque/Dyersville Medical Center's Mission and Values.
• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health's Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
• Maintains a professional, collaborative work environment so as to foster a positive public image for MercyOne Dubuque/Dyersville Medical Center.
• Knows and adheres to all laws and regulations pertaining to patient health, safety, and medical information (i.e., HIPAA, Stark, etc.).

• Attends required safety programs.
• Appropriately and consistently uses the personal protective equipment, infection control and isolation standards, required of the job.
• Knows and is in charge of and carries out departmental emergency procedures for fire, disaster and other emergency situations.
• Reports and removes unsafe equipment/furniture and completes work order.
• Ensures proper entrance of visitors by following unit protocol on answering front door video camera entrance.
• Asks for assistance when needed to assure safety for all involved.
• Maintains a safe working environment, completes nursing rounds, SBAR's as required, and practices safe working habits.

• Performs other duties consistent with purpose of job as directed.

• Coordinates daily staffing needs by matching census to acuity. Completes CMS required posting on staffing.
• Demonstrates clinical competencies.
• Communicates relevant clinical information to physicians and families (Medical DPOA) regarding the patient's condition.
• Reports progress toward outcomes/goals and/or changes in condition to other health team members.
• Maintains ongoing communication with interdisciplinary team members throughout the shift, at shift change, and transfer of care.
• Communicates with other team leaders and members throughout the shift to reassess and prioritize the needs of the unit.
• Documents completely, comprehensively, and legibly and in accordance with policy.

• Practice within the legal scope of a registered professional nurse as outlined in the Iowa Board of Nursing Practice Act and deliver competent care consistent with standards/policies defined by professional nursing organizations, MercyOne Dubuque/Dyersville Medical Center, and external regulators/accreditation/certifying organizations.

• Delegation of activities and care tasks to the Certified Nursing Assistant. Completes monitoring, education, and follow-up to ensure compliance with these delegated tasks.
• Makes an initial assessment of new admissions, or readmissions, within 30 minutes of the resident's arrival to the unit.
• Completes all areas of the admission assessment database within 24 hours of admission.
• Initiates the resident problem list and incorporates relevant medical history into the plan of care.
• Analyzes and interprets the assessment data to identify desired resident outcomes/goals.
• Prioritizes resident care needs/ activities. Evaluates patient response(s) to interventions. Review/modifies/revises the outcome-based plan of care based on ongoing reassessments.
• Identifies and makes appropriate referrals (i.e., Resident/Family Services, Nutritional Services, Spiritual Care, Diabetic Educator, Pharmacists, Hospice, etc.), and education needs.
• Coordinate physician rounds (i.e., primary care rounds, podiatry, dentist, dermatologist, etc.).
• Coordinate with the VA on residents' medications, incontinences, and other medical equipment.
• Determines nursing interventions to achieve those outcomes/goals. Collaborates with other health care disciplines to plan interventions/resident outcomes/goals.
• Assigns and coordinates resident care incorporating resident acuity and the skills, knowledge, and abilities of the team members.
• Implements the plan of care including procedures, treatments, physicians' orders, nursing orders, education plan and medications.
• Coordinates implementation of plan of care with the Therapies, Restorative Nursing, Social Worker, Hospice Nurse, and other health care disciplines.
• Uses nursing judgment to determine the appropriate frequency and components of reassessment. Reassesses at regular intervals to determine patient response(s) to interventions (minimum RN reassessment every 24 hours). Participates in develop discharge plan as appropriate.

• Utilize research and evidence-based practice standards in the delivery of patient care.
• Actively engage and participate in unit-based and central nursing/organizational committees and initiatives that advance nursing practice and quality of patient/family care.
• Continuously seek out opportunities to improve the quality of resident care delivery through innovative and creative problem solving.

• Utilizes the Patient Care Policies and Procedure as references to guide nursing practice.
• Assures medication safety by following the "5 Rights" of medication administration.
• Completes monthly unit changeover task (i.e., med exchange, EMR change, restorative and CNA documentation, etc.).
• Administers vaccines and immunizations for staff and residents under the discretion of Employee Health and the Medical Director.
• Prioritizes and implements intervention according to patient assessment.
• Demonstrates competency in computer systems and applications required for role.
• Receives, transcribes and processes and implements physician orders per policy including dating, timing and verifying accuracy.
• Maintains communication with the Director/MDS Coordinator and business office regarding admissions, unit needs, acuity and census numbers, MDS changes, VOICES, and significant events.
• Completes assigned shift duties and assures resolution of medication discrepancies.

• Support and participate in nursing shared governance and interdisciplinary decision-making. Participate in unit meetings, huddles, and special ad-hoc committees.
• Assists and completes restorative nursing and resident activities, especially on weekends and holidays when primary staff is not available.

• Demonstrate ethical conduct and practice consistent with the Code of Ethics for Nurses with Interpretive Statements.
• Contribute to the positive image of nursing and enhance the magnetic culture of the organization by modeling professional behavior both in the organization and in the community.
• Use and effectively integrate technology to support and document nursing activities and resident care.
• Serve as a teacher, mentor, and coach to residents, nursing and CNA students, new nurses, peers, other colleagues, and staff.
• Embrace change and lifelong learning, taking personal accountability to seek out experiences that reflect current practice in order to maintain skills and competence in clinical practice and role performance. Complete online training as due date assigned.
• Seek and incorporate feedback concerning improvement in one's own practice.

SKILLS AND ABILITIES REQUIRED:

• Maintains a professional, collaborative work environment to foster a positive public image for MercyOne Dubuque/Clinton. Medical Center.
• Knows and adheres to all laws and regulations pertaining to patient health, safety, and medical information (i.e., HIPAA, Stark, etc..).
• Serves actively on teams, committee, task forces, and work groups at the department, division, and organizational level.
• Ensures development and education of staff through competency assessments, in-services, continuing education, coaching/mentoring, attending department meetings, and participation in the performance appraisal process.
• Maintains expertise in the care of cancer, radiation oncology, breast, and lung cancer patients. Serves as a resource person for MercyOne Health Network.
• Provides a high level of customer responsiveness and serves as a role model to encourage a commitment to customer service. A strong service orientation is required.
• Maintains an excellent working relationship within the department and with all our internal and external customers.
• Ability to handle interactions with discretion, tact and courtesy when dealing with sensitive issues and confidential information.
• Must have well developed communication skills; strong interpersonal and collaborative skills with physicians and other healthcare professionals; strong decision-making skills that support patient care needs and ethical standards; and the ability to organize work and set appropriate priorities.
• Must have excellent written and verbal communication skills with the ability to relate to people across all levels and diverse backgrounds.
• Ensures that services are provided in a manner that supports continuous quality improvement and customer-oriented focus.
• Keeps supervisor informed about important issues.
• Requires professionalism in both dress and conduct on the job.
• Demonstrates an understanding of organizational dynamics and administrative procedures and protocols. Ability to function in a dynamic, fast-paced team environment and to cope with ambiguity, time constraints, and other daily stressors in an effective and appropriate manner.
• Demonstrates time management, prioritization and organizational skills including an ability and willingness to plan, organize and accomplish tasks accurately and in a timely manner to exercise sound judgment under pressure and to manage multiple and competing activities simultaneously.
• Must be able to work independently and productively in a fast-paced setting involving multi-task functions and projects. Ability to plan, organize and perform duties with minimal supervision and with a high degree of accuracy and attention to detail.
• Proven ability to identify, compile and present data effectively from many different sources for management decision-making.
• Must possess advanced analytical skills.
• Ability to demonstrate initiative.
• May require the ab...