To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The role of the Clinical Revenue Management Specialist II while incorporating the role of the Clinical Revenue Specialist I, is expected to demonstrate a higher level of comprehension and expertise in Clinical Revenue Management and act as a resource for the department. The CRMSII will identify opportunities for improving initiatives. Working with Leadership and staff, the CRMS II will contribute to content development within the department , provide informal and formal education to other departments, participate and organize projects related to CRM improvement

EEO/AA/Disability/Veteran

• 1. Independently and proactively seeks opportunities for learning (i.e. webinars, IFE classes, conferences etc.), provides feedback and applies to department needs. Responsible for education of new material to the staff.
• 2. Independently and proactively detects areas of opportunity within the department and pursues solutions via consultation with colleagues, investigation through outside resources and discussion with management to initiate a plan.
• 3. Conducts audits as assigned for CRM quality and accuracy and reports results to management.
• 4. Serves as a resourceful liaison to other departments, including but not limited to UR, verification, coding and billing.
• 5. Works with management to develop educational content in identified areas of opportunity for interdepartmental progress.
• 6. Organizes special projects in CRM. Acts as a resource to direct the project team. Involved in initiatives such as internal and external audits.
• 7. Functions as subject matter expert and actively participates in CRM department meetings as a problem-solver.
• 8. Ensures efficiency and productivity of the processes and workflows of the team, participating in orientation of new staff, reporting any issues to leadership,
• 9. Focuses on specific opportunities and projects identified by leadership and others within the organization to be impacted by CRM.
• 10. Contributes to ongoing CRM improvement initiatives, including formal and informal provider education plans related to clinical revenue management.
• 11. Explores CRM process creation and efficiency in new areas.
• 12. Expert in work queue and workflow management and serves as a resource to staff.
• 13. Engages with physician advisors, leads for Care Management, leads for Utilization Review, key members of CBS and CFS as needed to address identified issues/ concerns.
• 14. Identifies trends, variances, deficiencies, and problems utilizing aggregated data and information as part of the CRM department improvement program. Provider and group level CRM data trend analysis, issue identification and solution proposal to leadership.
• 15. Analyzes clinical and financial information from a variety of internal and external sources to help develop a strategic approach to the future of clinical revenue management
• 16. Serves as a leadership resource for coverage of PTO.

EDUCATION

RN with a Bachelor's of Science Degree. Masters Degree preferred.

EXPERIENCE

Strongly preferred a minimum of ten (10) years of relevant clinical experience in hospital acute care along with relevant experience in case management, care coordination, and/or utilization management in a hospital or insurance setting and two (2) years of recent experience in the CRMS role. Strongly preferred knowledge of finance and billing practices.

LICENSURE

Current licensure in the State of Connecticut as a Registered Nurse. Acts as a department representative when needed with the ability to communicate clearly and confidently to the program goals and issues using e-mail, in person communication, telephone and other Written and electronic forms of communication

SPECIAL SKILLS

Detail oriented, exceptional analytical and critical thinking skills as well as excellence in written and verbal communication. Adaptability to a wide variety of interpersonal encounters with the entire health system team. Working knowledge of billing, payer and Prospective payment systems. Proficiency with computer software including Microsoft Applications, communications applications such as Skype or Zoom, etc. Must be able to work collaboratively and independently. Must be flexible with responsibilities in order to meet departmental needs. Must have keen eye to detail. Ability to develop and maintain supportive, collaborative relationships with both clinical and financial professionals. Demonstrated interpersonal, verbal and written communication skills in dealing with inter and intradepartmental activities. Ability to track activities and communications across multiple health system services, payers and forums

PHYSICAL DEMAND

Acts as a department representative when needed with the ability to communicate clearly and confidently to the program goals and issues using e-mail, in person communication, telephone and other Written and electronic forms of communication