General Summary of PositionThe Nurse Auditor, Clinical Operations MFC DC and MD will coordinate all activities associated with clinical activities, including the development and review of training, and auditing materials, performing auditing of clinical team members including but not limited to Case Management (CM) and Utilization Management (UM), and preparation for the actual and mock NCQA audits. The Nurse Auditor will perform audits to evaluate individuals' compliance with clinical processes, National Committee for Quality Assurance (NCQA) standards, regulatory requirements, and of overall clinical program effectiveness and efficiency. The Clinical Nurse Auditor will report to and work closely with the Assistant Vice President (AVP), Clinical Operations to monitor, maintain, and support the clinical department to maintain a high level of quality performance and comply with regulatory requirements and accreditation standards. The Clinical Nurse Auditor participates on departmental and organizational project teams and plays a critical role in project implementation by soliciting requirements through interviews, workshops, and/or existing systems documentation or procedures and ensuring that all impacted processes and systems are evaluated. The Clinical Nurse Auditor works closely with the Clinical Department in assisting with the definition, documentation, training, and support for new required accreditation processes. As a member of the Clinical Operations team the Clinical Nurse Auditor will have an opportunity to support improved accessibility to key business information, ensure process integrity, and develop process flexibility which contributes to the success of the organization. The auditor will maintain current knowledge about NCQA, contract requirements, healthcare / industry trends, District regulations, and other compliance standards.*This position will cover both our MD and our DC teams* Primary Duties and ResponsibilitiesDemonstrates behavior consistent with MedStar Health mission, vision, goals, objectives and patient care philosophy.Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.Maintains current knowledge of MedStar Family Choice benefits and services available for enrollees.Conducts monthly file audits for all file requirements.Participates in and/or lead clinical Inter-rater Reliability Testing (IRR).Proactively communicates and collaborates within the Clinical Departments to identify key areas of focus and helps to develop and maintain a clinical audit plan that includes auditing, analyzing, strategizing, and developing process refinements and program improvements.Develops written summaries of specific key areas of training required for clinical staff based on audit results and works on developing programs with Clinical Operations to help clinical staff gain proficiency in their work and documentation processes.Monitors staff adherence to designated NCQA UM, NCQA Complex Care Management (CCM), contractual and regulatory requirements with ongoing assessment of performance.Works with the AVP, Clinical Operations to communicate recommendations for operational changes based on survey findings to clinical leadership.Participates in training activities for clinical staff to support adherence to NCQA and other regulatory and internal documentation standards/requirements.Participates in the training of the InterQual products for new UM staff and MD's and any updates as needed.Proctors/administers the Inter-rater Reliability Testing to applicable clinical staff.Conducts Utilization Management chart reviews to ensure that Clinical Screening Criteria (InterQual®) has been applied correctly.Supports business requirements for system and process improvements.Researches pertinent information as requested.Holds self and others accountable to meet commitments.Ensures diversity, equity, and inclusion are integrated as a guiding principle.Persists in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.Maintain current knowledge about NCQA Standards, DHCF contract requirements, healthcare / industry trends, District regulations, and other compliance standards and demonstrate proficiency with all MedStar Family Choice software systems that support the clinical operation and participates and contribute to meetings (staff meetings, committee meetings, etc.). Minimum QualificationsEducationBachelor's degree Nursing required Experience1-2 years Case Management and utilization review experience required and1-2 years Auditing required and3-4 years Diverse clinical experience required Licenses and CertificationsRN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the District of Columbia and Maryland Upon Hire required Knowledge, Skills, and AbilitiesSkilled in planning, executing, and evaluating audit gaps and developing performance improvement initiativesPossess exceptional interpersonal and communication skillsKnowledge of current trends in healthcare delivery and Case Management / utilization review criteriaAbility to use computer to enter and retrieve data.Ability to create, edit and analyze (Word, Excel and PowerPoint) preferred This position has a hiring range of $87,318 - $157,289

General Summary of PositionUnit Highlights Key Responsibilities As a Clinical Nurse, you will provide skilled, compassionate care to patients and families across a spectrum of needsfrom routine to highly complex. You will assess evolving patient conditions, identify actual and potential health concerns, and develop appropriate care plans. Interventions may be delivered directly or coordinated through collaboration with other members of the nursing teamWhat We OfferCulture- Collaborative, inclusive, diverse, and supportive work environment.Career growth- Career mentoring to help you pursue your passions and gain skills to enhance your value.Wellbeing- Competitive salary and Total Rewards benefits to help keep you happy and healthy.Reputation- Regional & National recognition, advanced technology, and leading medical innovations.QualificationsADN, BSN, MSN, or CNL from an accredited School of Nursing required.Prior Clinical Nursing Experience preferred.Active MD RN License or Active Compact State RN and Basic Life Support for Healthcare providers required. This position has a hiring range of $35 - $56.91

General Summary of PositionMedStar Health is looking for a Certified Nursing Assistant to join our teamat Franklin Square Hospital!The ideal candidate is aCertified Nursing Assistant who will provide our patients with extraordinary patient care bydemonstratinga strong knowledge in the field.This person will function as a member of the patient-centered care team to provide direct patient care activities under the supervision of a Registered Nurse for assigned patients and their families/significant others.Assistsmedical and nursing staff with procedures and/or tests and patients with ADLs (Activities of Daily Living). Performs specific care activities such as specimen collection, phlebotomy, electrocardiography (EKG), and documentation in the health record. Incumbents in this position may perform all, or a combination of the duties described depending upon the assigned work area and the specific needs of the patients and the department.Join one of the largest healthcare systems in the Baltimore-Washington metro region, also recognized as one of the "Healthiest Maryland Businesses". Apply today and learn how MedStar Health can be your nextgreat careermove!Primary Duties:Assistspatients with activities of daily living (ADLs) and personal hygiene, including bathing, mouth care, dressing, skin care, positioning, feeding, ambulation, toileting, and range of motion activities.Assistswith patient mobilization and rehabilitation, use of crutches and walkers, and transfer/transport of patients in wheelchairs and stretchers.Collects specimens; performs venipuncture/phlebotomy; and obtains EKGs.Assistsin the measurement and documentation of patient’s intake and output. Accurately takes and records patient’s vital signs, height and weight, pulse oximetry, point of care and waived testing and other pertinent data or information in the patient’s health record.Performs routine sterile, non-sterile and other treatments/activitiesidentifiedby Unit/Hospital policy includingtube feedings; ostomy care; Foley Catheter care; perineal care; simple dressing changes and wound care; turning and positioning; postmortem care and transportation of body to the morgue; andassistancewith the application, maintenance and removal of traction, casts, splints, and exercise equipment.Maintains the comfort, privacy, confidentiality, and dignity of each patient in the delivery of services. Performs patient observation duty and prepares patients to be seen by providers.Assistsproviders and registered nurses in patient examinations and procedures. Rounds on all assigned patients based on established standards. Participates in patient/family teaching as directed and responds to questions from patients, families and visitors in a prompt, courteous, and respectful manner, referring them toappropriate personnelif necessary. Reports changes in the patient's condition to the registered nurse and care team, as necessary. Ensures complete hand off to oncoming shift and obtains full hand off from outgoing shift. Initiates andassistsin CPR whenindicated.Maintains the cleanliness and safety of patient rooms/environment by distributing and changing linen/towels, removing used meal trays, checking bed siderails and safety restraints, etc.Assistswith environmental services support such as linen management, trash removal and cleaning patient rooms as needed. Transports and/or escorts patients during discharges, transfers, and/or medical appointments. Completes errands such as delivering specimens to the laboratory, equipment, and supplies, etc., asrequired. Receives and stocks equipment and supplies andmaintainsorderly supply and utility rooms.Qualifications:Completion of an approved nursing assistant certification program.High School Diploma/ GED or equivalent.Certified Nursing Assistant (CNA) certification from the relevant authority.Basic Life Support (BLS).Certified Phlebotomy Technician (CPT) certificationpreferred.Experience as a certified nursing assistant and general health care experience in acute care, long-term care or other settings preferred. This position has a hiring range of $18 - $28.73

General Summary of PositionMedStar Health Nursing BenefitsFree parking for associates at all 4 Baltimore hospitals System-wide RN referral bonus program - up to $6000 per RN & $4000 per LPN Increased charge, preceptor pay and tuition assistance Relocation assistance up to $5000 if you live 50 miles away from your location Evening differential from 3-7pMedical/Surgical-Post Surgical Unit Highlights48 private rooms 75% Med Surg Patients 25% Post Surgical Patients NICHE Certified (Nurses Improving Care for Healthsystem Elders) Fantastic opportunity to learn acute care nursingAvailable Roles:Part Time Days: two 12-hour shifts & every 3rd weekendKey Responsibilities As a Clinical Nurse, you will provide skilled, compassionate care to patients and families across a spectrum of needsfrom routine to highly complex. You will assess evolving patient conditions, identify actual and potential health concerns, and develop appropriate care plans. Interventions may be delivered directly or coordinated through collaboration with other members of the nursing teamWhat We OfferCulture- Collaborative, inclusive, diverse, and supportive work environment.Career growth- Career mentoring to help you pursue your passions and gain skills to enhance your value.Wellbeing- Competitive salary and Total Rewards benefits to help keep you happy and healthy.Reputation- Regional & National recognition, advanced technology, and leading medical innovations.QualificationsGraduate of an accredited School of Practical Nursing.Must be quantifiable (i.e. minimum of 1 year experience within a Rehabilitation or acute setting).Valid LPN license in the State of Maryland required and CPR certification required at the end of introductory period (90 days). This position has a hiring range of $23.3300 - $37.8200

General Summary of PositionMedStar Health is looking for aCoding Specialist III with extensive experience in Neurosurgery codingto join ourREMOTEteam!As a Coding Specialist III you will ensure that MedStar Health's medical-professional services are coded correctly and completely, based upon extensive, complete, up-to-date knowledge of regulatory and specific payer requirements. Recommends policy and a procedural change to obtain optimum reimbursement for services rendered. In addition to interacting with physicians on coding issues, ensures that physician encounter forms, the GE IDX billing system and processes are up to date and compliant regarding coding issues. Assists manager as required. Mentors and reviews work of Coding Edit Specialist, Coding Specialist I and Coding Specialist II as required. Primary Duties and ResponsibilitiesAbstracts and ensures accuracy of diagnosis, procedure, patient demographics, and other required data elements.Aids in the creation of training and educational coding guidance documents for physicians and MMG Associates.Assists in developing guidance to clinicians in optimizing dictations to promote compliance and claim to process.Assists in the maintenance of billing, coding, and editing dictionaries in the billing system.Consistently meets or exceeds established Quality, Accuracy, and Productivity standards as defined by policies.Contacts physician when conflicting or ambiguous information appears in the medical record. Requests diagnosis from physicians when not recorded in medical records.Determines the sequence of diagnoses for accurate claims submission.Employs knowledge of coding compliance, and directs efforts to achieve quality standards identified through coding reviews or targeted by management for improvement.Guides and provides mentoring related to coding projects done by Coding Specialist I and Coding Specialist II to include review and correction of code selection based upon medical documentation.Handles complex coding case review, including but not limited to surgical coding (Orthopaedics, Cardiac, Neurosurgery, Otolaryngology, etc.) extraction, co-surgery scenarios, multi-visceral transplant cases, comorbidity evaluation.Identifies and reports issues and trends in physician documentation and/or work routed to Coding from other departments.Identifies coding trends relative to edits/denials/physician feedback.Maintains continuing education and credentials as required for job classification.Provides guidance to Coding Specialists I and II related to complex edit and appeal scenarios.Recommends policy and procedural changes and improvements for revenue enhancement.Surveys Medical Professional Societies coding guidelines to ensure the usage of current coding combinations and rationale. Minimum QualificationsEducationHigh School Diploma or GED required; Bachelor's degree preferred Consideration will be given to appropriate combination of education, training and experience Experience5-7 years Medical-professional coding experience with demonstrated ability to work independently required 2 years experience leading others or leading a work stream required Experience with computer systems for encoding and abstracting required and Additional years of experience strongly preferred Licenses and Certifications CPC (Certified Professional Coder) certification required Knowledge, Skills, and AbilitiesDemonstrated attention to detail accompanied by outstanding organizational skills.Ability to interact effectively with physicians, liaisons, department administrators, and associates.Ability to work independently and practice self-direction.Working knowledge of payer policies, CMS policies, local and national regulatory and compliance policies; regular utilization of all available coding resources.Ability to toggle between specialty coding disciplines, including ancillary services, Anesthesia, Emergency Medicine, Radiology, Pathology and others.Verbal and written communication skills.Basic computer skills preferred. This position has a hiring range of $28.2 - $47.3

General Summary of PositionMedStar Health is seeking experienced Inpatient Coding Specialists that are self-motivated and haveat least 3 years of inpatient acute care coding experience with knowledge in MS-DRG and/or APR-DRG.Qualified candidates must have their CCS (Certified Coding Specialist) through AHIMA.Selected candidates will enjoy full time, Monday – Friday, day-shift REMOTE schedule.Join one of the largest health systems in the Mid-Atlantic area and enjoy the benefits of a comprehensive benefits package including paid time off, health/vision/dental insurance, short & long term disability, tuition reimbursement and the benefits of remote work capability.Job Summary- Codes and abstracts primarily Inpatient acute care records using ICD-10-CM/PCS and other applicable patient classification schemes.#LI-remote Primary Duties and ResponsibilitiesAbstracts and ensures accuracy of diagnoses, procedure, patient demographics, and other required data elements.Adhere to all compliance regulations and maintains annual compliance education.Maintains continuing education and seeks ongoing education to improve job performance. Maintains credentials as required for job classification.Contacts physician when conflicting or ambiguous information appears in the medical record. Adheres to the MedStar Coding Query Policy and procedure.Meets established Quality standards as defined by policies.Meets established Productivity standards as defined by policies.Resolves all quality reviews timely (e.g. Medical necessity reviews; Coding Quality assurance reviews; external vendor reviews).Reviews medical record documentation to identify diagnoses and procedures. Assigns correct diagnostic and procedural codes using standard guidelines and automated encoding software maintaining departmental accuracy standards. Determines the sequence of diagnoses according to Uniform Hospital Discharge Data Definitions and assigns appropriate DRG (Diagnosis Related Groups).Exhibits knowledge of the 3M system and other work-related equipment. Minimum QualificationsEducationHigh School Diploma or GED required; Associate degree or Bachelor's degree in coding related degree preferred Courses in Medical Terminology, Anatomy & Physiology, ICD-CM and ICD-PCS required Experience3-4 years Inpatient coding experience required Experience with clinical information systems (3M grouper, electronic medical records, computer assisted coding) preferred Licenses and Certifications CCS (Certified Coding Specialist) required RHIT (Registered Health Information Technician) and/or RHIA (Registered Health Information Administrator) preferred Knowledge, Skills, and AbilitiesVerbal and written communication skills.Basic computer skills required. This position has a hiring range of $28.20 - $47.30

General Summary of PositionMedStar Ambulatory Services is currently seeking a CPC Certified Coder with1 - 2years of coding experienceto join our team! This is a full time, Monday-Friday position, with a hybrid schedule after the successful completion of the 90-day probationary period. Hybrid schedule includes working remotely on Mondays & Fridays and working on-site Tuesday - Thursday. Business office is located in Elkridge, MD (will be relocating to Columbia, MD).Job Summary - Codes and abstracts Ambulatory Surgery Center (ASC) services using CPT, ICD-10-CM, HCPCS and other applicable patient classification schemes. Primary Duties and ResponsibilitiesContributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.Abstracts and ensures accuracy of diagnoses, procedure, patient demographics, and other required data elements.Adhere to all compliance regulations and maintains annual compliance education.Maintains continuing education and seeks ongoing education to improve job performance. Maintains credentials as required for job classification.Contacts physician when conflicting or ambiguous information appears in the medical record. Adheres to the MedStar Coding Query Policy and procedure.Meets established Quality standards as defined by policies.Meets established Productivity standards as defined by policies.Resolves all quality reviews timely (e.g. Medical necessity reviews; Coding Quality assurance reviews; external vendor reviews).Reviews medical record documentation to identify diagnoses and procedures. Assigns correct diagnostic, procedural codes, and appropriate modifiers using standard guidelines and maintaining departmental accuracy standards.Exhibits knowledge of other work-related equipment. Minimum QualificationsEducationHigh School Diploma or GED required; Courses in Medical Terminology, Anatomy & Physiology, ICD-CM CPT-4 required; Associate degree in coding related studies or Bachelor's degree in coding related studies preferred Experience1-2 years Coding experience and experience with clinical information systems (3M grouper, electronic medical records, computer assisted coding) preferred Licenses and CertificationsCertified Professional Coder (CPC) required Knowledge, Skills, and AbilitiesVerbal and written communication skills.Basic computer skills required. This position has a hiring range of $23.19 - $40.61

General Summary of PositionCodes and abstracts primarily Ambulatory Surgery records and other outpatient records using ICD-10-CM, and other applicable patient classification schemes. Primary Duties and ResponsibilitiesAbstracts and ensures accuracy of diagnoses, procedure, patient demographics, and other required data elements.Adhere to all compliance regulations and maintains annual compliance education.Maintains continuing education and seeks ongoing education to improve job performance. Maintains credentials as required for job classification.Contacts physician when conflicting or ambiguous information appears in the medical record. Adheres to the MedStar Coding Query Policy and procedure.Meets established Quality standards as defined by policies.Meets established Productivity standards as defined by policies.Resolves all quality reviews timely (e.g. Medical necessity reviews; Coding Quality assurance reviews; external vendor reviews).Reviews medical record documentation to identify diagnoses and procedures. Assigns correct diagnostic, procedural codes, and appropriate modifiers using standard guidelines and automated encoding software maintaining departmental accuracy standards.Exhibits knowledge of the 3M system and other work-related equipment.CUSTOM.PRIMARY.DUTIES.RESPONSIBILITIES.ADDENDUM Minimum QualificationsEducationHigh School Diploma or GED required Associate's degree or Bachelor's degree in coding related degree preferred Courses in Medical Terminology, Anatomy & Physiology, ICD-CM and CPT-4 required Experience2 years ASU (Ambulatory Surgery) coding experience and experience with clinical information systems (3M grouper, electronic medical records, computer assisted coding) required Licenses and Certifications CCS (Certified Coding Specialist), CCS-P (Certified Coding Specialist-Physician-based) required or COC (Certified Outpatient Coder) required RHIT (Registered Health Information Technician) preferred and/or RHIA (Registered Health Information Administrator) preferred Knowledge, Skills, and AbilitiesVerbal and written communication skills.Basic computer skills required. This position has a hiring range of $28.2 - $47.3

General Summary of PositionMedStar Health is seeking an experienced Inpatient Coding Specialist that hasat least 6 months - 1 year of inpatient acute care coding experience with knowledge in MS-DRG and/or APR-DRG.Qualified candidates must be able to obtain their CCS (Certified Coding Specialist) through AHIMA within one year of hire.Selected candidates will enjoy full time, Monday – Friday, day-shift REMOTE schedule.Join one of the largest health systems in the Mid-Atlantic area and enjoy the benefits of a comprehensive benefits package including paid time off, health/vision/dental insurance, short & long term disability, tuition reimbursement and the benefits of remote work capability.Job Summary - Codes and abstracts primarily Inpatient records using ICD-10-CM and other applicable patient classification schemes. Minimum QualificationsEducationHigh School Diploma or GED equivalent required and Courses in Medical Terminology, Anatomy & Physiology, ICD-CM and ICD-PCS required Associate's degree in coding or Bachelor's degree in coding related degree preferred; Experience Experience with clinical information systems (3M grouper, electronic medical records, computer assisted coding) and coding experience Licenses and Certifications CCS (Certified Coding Specialist) through AHIMA required within 1 year from date of hire. RHIT (Registered Health Information Technician) and/or RHIA (Registered Health Information Administrator) preferred Knowledge, Skills, and AbilitiesVerbal and written communication skills.Basic computer skills required. Primary Duties and ResponsibilitiesAbstracts and ensures accuracy of diagnoses, procedure, patient demographics, and other required data elements.Adhere to all compliance regulations and maintains annual compliance education.Maintains continuing education and seeks ongoing education to improve job performance. Maintains credentials as required for job classification.Contacts physician when conflicting or ambiguous information appears in the medical record. Adheres to the MedStar Coding Query Policy and procedure.Meets established Quality standards as defined by policies.Meets established Productivity standards as defined by policies.Resolves all quality reviews timely (e.g. Medical necessity reviews; Coding Quality assurance reviews; external vendor reviews).Reviews medical record documentation to identify diagnoses and procedures. Assigns correct diagnostic and procedural codes using standard guidelines and automated encoding software maintaining departmental accuracy standards. Determines the sequence of diagnoses according to Uniform Hospital Discharge Data Definitions and assigns appropriate DRG (Diagnosis Related Groups).Exhibits knowledge of the 3M system and other work-related equipment. This position has a hiring range of $28.20 - $44.83