RN Leader, Clinical Revenue Integrity & Appeals

University of Chicago Medicine; Illinois; Sur place; USD 115 000 - 155 000; Plein temps

Résumé du poste

University of Chicago Medicine seeks a RN Manager for the Revenue Cycle Department to lead a team focused on clinical revenue integrity and payer appeals. The role drives denial prevention, medical necessity validation, and evidence-based appeal development system-wide.

The position oversees nursing staff collaborating with physicians, case management, utilization management, patient access, coding, and payer organizations to optimize reimbursement while ensuring compliance with CMS and payer

Qualifications

• Bachelor's degree in Nursing (BSN) is required.
• Five (5) years of progressive clinical experience in acute care, utilization management.

Responsabilités

• Provides direct leadership, coaching, and performance management for a RN team.
• Establishes standardized workflows, productivity expectations, and quality standards.
• Drives denials prevention and optimal reimbursement through clinical review and documentation.
• Collaborates with Revenue Cycle, Utilization Management, Patient Access, Case Management, and Coding teams.
• Develops action plans to address root causes of denials and improves outcomes.
• Prepares executive reports summarizing performance and financial impact.

Connaissances

Leadership

Coaching

Performance management

Cross-functional collaboration

Quality improvement

Formation

Bachelor's degree in Nursing (BSN)

Description du poste

University of Chicago Medicine seeks a RN Manager for the Revenue Cycle Department to lead a team focused on clinical revenue integrity and payer appeals. The role drives denial prevention, medical necessity validation, and evidence-based appeal development system-wide.

The position oversees nursing staff collaborating with physicians, case management, utilization management, patient access, coding, and payer organizations to optimize reimbursement while ensuring compliance with CMS and payer