Buscar empleo: 335 ofertas de trabajo de insurance compliance en Albany, New York (septiembre 2025)

Albany Medical Center

RN - Cardiothoracic Surgery Office

hace 3 días

West Sand Lake

Department/Unit: HBD - Surgery Thoracic Work Shift: Day (United States of America) Salary Range: $83,200.00 - $128,960.00 RN for Cardiothoracic division outpatient office within the department of surgery. Collaborative team effort to provide optimum care to patients requiring scheduled and emergent surgical care. This position supports the thoracic team but also cross covers the cardiac team when required. Under the supervision of the Nursing Supervisor and Nurse Manager, the Ambulatory Care RN provides nursing support to primary and subspecialty providers. This is demonstrated by the use of the nursing process to work collaboratively with the healthcare team in planning, directing, providing, and evaluating patient care. The Ambulatory Care RN is defined within the department to provide patient care, triage, consultation, and referral among team members. Essential Duties and Responsibilities: Generally include the following. Other related duties may be assigned: Support for Self-Management * Enhances health literacy * Performs a baseline comprehensive needs assessment reflecting patient values, preferences, and goals (in person or via telehealth). * Analyzes patient care needs and utilizes a systematic approach to the delivery of care. * Provides age-appropriate direct patient care including family and patient. Advocacy * Negotiates and secures patient services; coaches the patient in self-advocacy * On the phone and at the office visit, listen to the patient and family goals and concerns. Works with patients, insurance companies, home care agencies, etc. to access providers, community services, medications. * With an initial order of medications, enteral formulas, - verifies if PA needed, or med not covered at all, reviewing other possible options for non-formulary med, clarifying orders, renewing orders Education and Engagement of the patient and family * Assess readiness to learn/learning styles. * Provides patient and family education taking into consideration cultural, religious, language, and motivational, physical, emotional, and cognitive factors into account in the teaching plan * On the phone or in the office instructs about nursing care plans related to results of labs, tests, procedures, medication changes, dietary changes, other changes in interventions. * Provides education regarding interventions and requests, “teach-back” to ensure understanding (in person and via telehealth). * Performs telephone triage including coordination of care and documentation. * Works with physicians and other resources to develop teaching tools for families and patients and/or utilizes educational resources on Intranet. Cross setting communication and transition * Develops the individualized care plan; care planning activities transcend barriers/transitions keeping the patient at the focus. * Nurses utilize evidenced-based practice to plan and implement nursing care plans (interventions and outcomes). * The plan is updated with every phone call, office visit, inpatient admission, etc. * Coordinates and collaborates between specialty and primary providers who develop and share the patient care plan across settings * Care plan transmitted between setting, changes, and updates communicated * Discusses the discharge plan of care for patients that are inpatient and coordinates follow-up interventions needed. * Coordinates admissions with communication regarding the plan of care. * Coordinates referral to the emergency room * Takes calls by MD offices to discuss coordination of care that cannot be addressed by faxing the most recent office visit note. * Works with other departments inside and outside of AMC to coordinate multidisciplinary care * Coordinates home care – setting up for supply deliveries, clarifying verbal orders * Coordinates infusions- insurance, orders, communication to patient, education * Supplies inpatients with educational information as needed * Coordinates referrals to social services departments, WIC * Facilitates the utilization of resources to meet patient outcomes (case management). * Writes letters of medical necessity as indicated * Participates in the patient throughput process in the clinic as indicated and needed (including vital signs, updating medical records, performing diagnostic procedures, assisting the physician and practitioners, facilitating teaching, end of appointment coordination of care) Coaching and counseling of patients and families * Answers questions patients have before and after provider visit. * Patients are directed to bring questions to the visit and/or calls and answers are secured, before, during, and after the visit (in person or via telehealth). * Documents properly, giving age-appropriate care, gathering data correctly (including vital signs), and facilitating care in a customer-friendly manner. * Performs diagnostic tests such as impedance studies, wireless capsule endoscopies Nursing Process * Assesses patient for knowledge understanding diagnosis, needs, treatment, expected outcomes of treatment. * The best evidence is used for interventions/outcomes; the care plan is routinely updated. Teamwork and Collaboration * Inclusion of teamwork in orientation and continuing education-interdisciplinary. * Enhanced utilization of interdisciplinary resources. * FMLA paperwork, CPS paperwork, 504 plans– coordination of care Patient-Centered Care planning * Motivational interviewing; eliciting patient’s goals and priorities. * Individualized care plan; care planning activities transcend barriers/transitions keeping the patient at the focus Understands and supports their role in regulatory /compliance issues/the health care team. * Maintain division medical records * Completes organized and quality documentation as required by the department. * Works with division physicians, administrative staff, and Nurse Manager to assure compliance with regulatory conditions and policies and procedures * Actively participates in the survey process in regards to accreditation * Maintains compliance with regulatory agencies * Realizes their role in Environment of Care Surveys. * Maintains a safe environment within the clinic and working office space * Maintains compliance with AMC standards for electronic system use * Maintains compliance with AMC Code of Conduct * Collaborates with administrative staff and physicians on the Quality Improvement Team to address clinical and non-clinical issues within the division * Locates regulations and policies and procedures online and know how to apply to current job * Utilizes educational resources on Intranet for self-education and education of other staff * Utilizes the Chain of Command as indicated * Ensures that medical equipment functioning properly and knows the process to manage failure as the need arises * Cross covers in other divisions within the department as needed * Orientation of new staff * Delegates daily tasks to appropriate clinical staff and ensures completion of tasks * Reviews and triages incoming test results as indicated within the division. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * HS diploma or GED * Graduate of state-accredited Registered Nursing program * Current license to practice professional nursing in the State of New York * Current CPR certification required. * Certification in specialty preferred Experience: * Skills required for the position: * Strong customer service orientation * Strong communication skills * Flexibility in time * Ability to effectively present information and respond to questions from physicians, patients, and their family members or other employees within the work setting. * Familiar with computer software including MS Word and Excel * Effective Written and Verbal Communication Skills * Experience with electronic health records is preferred * Ability to Maintain Confidentiality. * Thorough knowledge of organization, department, and/or section policies and practices related to position preferred * Ability to administer medications via all routes and ability to calculate medication doses. * Proficiency in the operation of standard office equipment (Adding Machine, Fax, Photocopier, Credit Card Machine) and clinical equipment (Sphygmomanometer, Electronic Vital Signs machine, pulse oximetry machine, infant scale, adult scale, and stadiometer), * Type 45-60 WPM on a Typewriter or Computer Work Environment (including Hazards): A clinical care setting requires the ability to lift a minimum of 10 pounds, extensive walking, and standing. May be subjected to infectious materials and chemicals (i.e. HLD Solutions, disinfectant sprays, or wipes). ***This is the best faith effort to clearly define the nature of this position; responsibilities may be added or deleted based upon the ever-changing needs of management. The individual in this position must have the ability to adapt to change and to be flexible concerning day-to-day work responsibilities. Thank you for your interest in Albany Medical Center! Albany Medical is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

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