RN-Case Management Cover Letter

I submit this application to express my sincere interest in the rn-case management position.

In my previous role, I was responsible for leadership and guidance in ensuring compliance and accuracy with the use of InterQual criteria, Joint Commission and other regulatory requirements.

My experience is an excellent fit for the list of requirements in this job:

• Background and understanding of Treatment Modalities
• CPR optional
• Current licensure by Tennessee Governing Boards
• Demonstrated working knowledge of QI, UM, benefit plans fiscal management, and various payment methodologies
• Conduct telephonic education to promote self-management strategies for specific chronic conditions (asthma, prediabetes, diabetes, and cardiovascular disease and obesity)
• Current California RN License and American Heart Association BLS for Healthcare Providers
• Clinical understanding of hospital and ambulatory patient care delivery systems
• Demonstrated knowledge of managed care operations

I would like to submit my application for the rn-case management opening. Please accept this letter and the attached resume.

In the previous role, I was responsible for clinical reviews in a timely manner utilizing InterQual criteria, and follow review protocols for the department.

Please consider my experience and qualifications for this position:

• Excellent knowledge of case management principles, healthcare management and reimbursement
• Previous experience with psychological aspects of care
• BSN and CCM (Certificate of Case Management)
• Home health background
• Active Virginia Registered Nurse license
• Knowledge of utilization review and admissions criteria for all levels
• Knowledge of health plan benefit coverage and regulations
• Demonstrated independent judgment and action skills in order to facilitate needed change in practice

I submit this application to express my sincere interest in the rn-case management position.

In the previous role, I was responsible for discharge notices and Important Message from Medicare to patients with explanation of patient s rights as directed by case management staff.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Knowledge of California Health and Safety Act, NCQA, DMHC, CMS and DHS regulations
• Demonstrated strong oral and written communication, problem-solving and analytical skills as related to Utilization data and analysis
• Strong computer skills with MS Outlook, Word, Excel, use of Electronic Health Record and UM software for complex case management or utilization authorization /denial
• Case Management experience in acute care setting, with significant knowledge of Case Management process, including care coordination, utilization review and discharge planning, preferred
• Certification in Case Management Nursing
• Home health or community nursing experience strongly preferred
• Requires fundamental knowledge of the revenue cycle process, which includes such things as patient access, utilization review, charge capture, HIM and patient accounting
• Requires the advanced analytical and critical thinking skills necessary to audit patient care data, associated patient care documentation and identify variances in standards of care

In response to your job posting for rn-case management, I am including this letter and my resume for your review.

In the previous role, I was responsible for administrative support to Inpatient Case Management team as needed to support case management workflow process on a daily, weekly and monthly basis.

Please consider my experience and qualifications for this position:

• Requires knowledge of rules and regulations pertaining to hospital reimbursement
• Requires familiarity with managed care principles and an understanding of post-acute continuum of care
• Requires the interpersonal skills necessary to maintain effective working relationships and interact effectively with staff, physicians, review agencies, insurance companies, patients and patients'' families
• Requires the effective communication skills (both verbal and written) necessary to prepare documentation, write appeal letters and to provide education to staff and physicians regarding the revenue cycle process
• Demonstrates a working knowledge of the Hospital''s computer systems and proficiency in basic computer skills (i.e., data entry, word processing, spreadsheets, utilizing the internet)
• Demonstrates knowledge of and a commitment to North Central Surgical Center''s mission and values and the organization''s goal of providing world class service
• Experience with Observation and RAC initiatives
• Certification in Case Management is preferred

I submit this application to express my sincere interest in the rn-case management position.

In the previous role, I was responsible for case management services in accordance with the Case Management Society of America (CMSA) standards of practice for members enrolled within the respective ICDS case management programs.

Please consider my qualifications and experience:

• Demonstrated analysis skills (clinical, operational, customer service, financial)
• Proficient in computer skills (e.g., Microsoft Word, PowerPoint, Access, Excel, and Visio)
• RN with BSN is preferred
• Advanced Care Management knowledge
• Certification from Association of Case Management
• Thorough clinical knowledge of disease process
• Knowledge of relation of DRG, ICD9 and CPT codes, relationship to physician documentation and insurance billing requirements
• Knowledge of relevant laws, regulations, and safety requirements and standards