Manager, Epic CM Educator

Shift: Day
Schedule: Full - Time Regular

Ardent Health Services invests in people, technology, facilities and communities, producing high-quality care and extraordinary results. Based in Nashville, Tennessee, Ardent’s subsidiaries own and operate 31 hospitals in seven states with more than 25,000 employees including 1,150 employed providers. Ardent facilities exceed national averages in Overall Hospital Quality Star Rating as ranked by the Centers for Medicare & Medicaid Services; 89 percent of its hospitals received a three-star rating or above in comparison with 73 percent of all hospitals ranked. Five of the company's hospitals were recognized by Modern Healthcare as "Best Places to Work" in 2018 - the eleventh consecutive year an Ardent facility made this list. Ardent's corporate office was named "Top Work Places" for Nashville based companies in 2017 and 2018.

We have an exciting opportunity to join our team as a Manager, Epic CM Educator. This position has the ability to work remotely from home and travel to our facilities.

Reporting to the AVP of Case Management, the Manager, Epic CM Educator shall provide education to all EPIC facilities to ensure that standard workflows are utilized as well as provide extensive support as new facilities of Ardent with their EPIC activation. This will include process improvement of current workflows as well as development of more extensive EPIC Case Management education over the period of their initial orientation to the Case Management department at the facility level. Education updates to current usage of EPIC CM/UR workflows include review of case management documentation, case management processes, utilization review processes and documentation, assisting with education for case management staff at all ardent facilities as needed. The Corporate EPIC Case Management Educator will assist in the future optimizations and development of EPIC for consistent, reliable CM processes and practices across all Ardent EPIC facilities.

PRIMARY RESPONSIBILITIES

  • Provides EPIC education to all new CM/UR staff across the AHS facilities.
  • Enhancement and development of EPIC CM/UR education.
  • Identify new report development with education and communication of all available reports to each Ardent Facility.
  • Improvement of facility processes and procedures to assure timely and accurate CM/TOC/UR processes.
  • Develop clinical in-services and education programs for facility staff and establish procedures for timely and accurate for CM/TOC/UR delivery.
  • Develop and maintain collaborative working relationship with all Ardent facilities including CM/TOC/UR, Administration and all other departments that impact Case Management processes.
  • Inter-relate with department managers to identify trends and issues.  Assist in directing resolution of the issue.
  • Document identified issues using current tools or develops new tools to enhance process.
  • Monitor identified issues and the timeline for resolution.
  • Document financial impact of identified issue.
  • Address revenue cycle QA issues as needed.
  • Monitor and trend CM/TOC/UR processes to identify opportunities for process improvement.
  • Function as a resource to the CM/TOC/UR departments and Facility Administration. 
  • Complies, reconciles and distributes reports timely to the appropriate personnel.
  • Conduct medical chart and process reviews for potential opportunities to improve Case Management, TOC and UR system-wide. 

Education:

  • Prefer a Bachelor’s Degree in Nursing or Licensed Master Level Social Worker with Case Management certification required (ACM or CCM). 
  • An ACM or CCM certification is required for the position or must be obtained in 1 year.

Work Experience: 

  • A minimum of four years of experience as an RN Case Manager, Utilization Review RN or LMSW Case Manager.
  • 1+ years of EPIC CM experience preferred.
  • Experience auditing and reviewing medical records preferred. Knowledge of crystal reports as well as extensive experience with using Word and Excel spreadsheet formats.
  • Proficiency with PowerPoint is a plus.
  • Knowledge of hospital operations, hospital department case management, TOC, and utilization review, revenue cycle services and CMS regulations. 
  • Extensive knowledge of all CMS regulations regarding Conditions of Participation for Discharge Planning, OPPS and IPPS documentation regulations,

 

Additional Requirements:

  • Communication skills and developing a rapport with hospital administration, department managers, and case management staff are paramount to identifying issues and developing standardized Case Management practices.
  • Must be detail oriented and work both independently and collaboratively with various administrative and clinical staff. 
  • Requires willingness and ability to travel up to 50% or greater.
  • Must have a thorough knowledge of hospital operations, hospital case management functions, LOS monitoring revenue generation, and Medicare regulatory environment. 
  • Must be detail oriented and work both independently and collaboratively with various administrative and clinical staff. 
  • Must be professional comfortable to work with a variety of department managers.
  • Must have the technical knowledge of correct coding principles of CPT-4 / HCPCS and modifier assignment.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.