Source:  Fierce Healthcare

A recent article from Fierce Healthcare highlights how one healthcare system uses a team approach toward reducing denials.  The case study examines a three-hospital healthcare system that had a dramatic improvement in results from 2008 to 2010 after implementing effective team approach steps.

Here are the highlights:

2008

• 77 days in accounts receivable on average
• Low cash on hand
• 99% percent of the hospital’s claims rejected on the first try

2010

• 37 days in accounts receivable on average
• Tripled cash on hand
• 3% denied claims on first try

Some of the steps they took to achieve these results:

• Counting errors
• Tweaking health information system
• Adding new scrubbing software
• Training revenue-cycle staff
• Educating the clinical team

For details of this remarkable case study visit Fierce Healthcare: Revenue-cycle case study: Reducing denials requires team approach

What steps does your healthcare organization take to help reduce denials?
Include your response in the “Leave a Reply” section.

Source: CNN Health

Moving from bedside nursing into case management, utilization review, quality, appeals or other non-bedside nursing jobs may have quite an impact on your health.  The transition from being on your feet all day to a desk job can be significant for some nurses.

This CNN Health article offers advice to help you combat the aches and pains that come with moving to a desk job.

Read the full story at CNN Health.

Source:  Commission for Case Manager Certification

“The role case managers play in health care is expanding with new team-based delivery models. To meet the challenges of their expanding role, case managers are becoming better prepared educationally and professionally to meet the requirements of employers, consumers and payers, according to a study by the Commission for Case Manager Certification (CCMC).

CCMC surveyed nearly 30,000 case managers and analyzed the results from 6,909 completed surveys to create a detailed profile of the role of case managers today, and the functions they perform across care settings.”

Here are some highlighted findings from the study:

• More case managers hold bachelor or higher degrees (65 percent in 2009 compared to 60 percent in 2004)
• Certification in case management is required by more employers (36 percent, compared to 26 percent in 2004)
• More employers offer additional compensation for certification (27 percent in 2009 compared to 20 percent in 2004)
• The case manager role represents a career advancement opportunity for nurses
• The case manager role is becoming more challenging, and more important within the health care system

Read the complete press release from CCMC:  Survey Finds More Case Managers Professionally Credentialed, Hold Higher Degrees

First Survey to Look at Non-Bedside / Non-Clinical Nursing Salaries in New York, New Jersey and Pennsylvania.

Pathway Medical Staffing recently released the first annual RN Salary Survey of Non-Clinical / Non-Bedside Nurses.  While there are several published surveys that detail salary trends for nurses, few look at the registered nurse subset in  non-clinical / non-bedside nursing.

This survey examines salaries for experienced registered nurses placed in case management, appeals/denials, utilization review, quality improvement and clinical documentation improvement (CDI) positions, specifically in New York, New Jersey and Pennsylvania. The data analyzed in the survey is drawn from documented base salary data for hundreds of registered nurses in these specific non-bedside nursing positions.

2010 Registered Nurse Salary Survey Highlights:

“Average salary in 2009 for a non-clinical / non-bedside registered nurse in the New York Metro area was $83,592.  This is trending upward as of the first quarter 2010.”

“More experience in non-clinical nursing does not always equate to a higher salary.”

“Registered nurse salaries in utilization review, quality improvement and appeals / denials all increased by more than 14% in 2009.”

“Director level salaries in non-clinical / non-bedside nursing were down 30% in 2009 and the trend appears to be continuing in 2010.”

“Non-clinical / non-bedside registered nurses with ‘work at home’ jobs earned an average of $68,000 per year.”

“Registered nurses with a higher level educational degree (BSN, MSN, PhD) earned up to 6.4% more than registered nurses with an associates degree or a diploma in nursing.”

“Registered nurses in non-clinical / non-bedside roles at hospitals earned an average of 5% more than their counterparts working for managed care organizations in 2009.”

For complete survey results, download the 2010 Registered Nurse Salary Survey.

Looking for More Nursing Salary Information?
For more information about nursing salary trends in your area the “Nurse Salary Guide” provides several resources with data from various leading sources.

About Pathway Medical

Since 1998 Pathway Medical Staffing has specialized in recruiting non-bedside and non-clinical nursing professionals for full-time and temporary positions at leading healthcare organizations.  To learn more about Pathway Medical Staffing visit www.pathway-medical.com.

What is Nursing Beyond the Bedside?

Nursing Beyond the Bedside is a free LinkedIn networking group that is open to nurses with experience, questions and interest across all disciplines in non bedside nursing.

This free networking group is a community of nurses working in, or interested in, non bedside / non clinical nursing, including: nurse case management, utilization review, appeals/denials, clinical documentation improvement, risk management, HEDIS, quality improvement, medical record review, nurse informatics, nurse education and any non bedside nursing profession.  The group is a place for nursing professionals to ask questions, share experiences, read current news and find jobs and career advice in non bedside nursing.

There are so many networking groups for nurses, why create another one?

There are many networking groups for nurses on the Internet, but most focus on nursing education and staff / bedside nursing. 

While there are a few networking groups for non bedside nursing, most are focused on specific disciplines within non bedside nursing such as:

Case Management:  Case Management Society of America

Quality: American Health Quality Association

Risk: American Society for Health Risk Management

Compliance: American Association of Medical Audit Specialists

We have found that many nurses have a need for information across all of these disciplines, but lack a singular networking group to connect with their peers. This is especially true for nurses working in smaller organizations who are often responsible for multiple roles across the non bedside nursing spectrum.

In response to this demand, we have created Nursing Beyond the Bedside. The group is intended to be a place for all nurses in these various non bedside roles to ask questions, share expertise, read the latest news, find career advice and share job opportunties with their peers.

We welcome you to join us and your fellow nurses on the Nursing Beyond the Bedside group on LinkedIn.  

First Survey to Look at Non-Bedside / Non-Clinical Nursing Salaries in New York, New Jersey and Pennsylvania.

At the end of the month, Pathway Medical Staffing will release the first annual RN Salary Survey of Non-Clinical / Non-Bedside Nurses. While there are several published surveys that detail salary trends for nurses, few look at the registered nurse subset in non-clinical / non-bedside nursing.

This survey examines salaries for experienced registered nurses placed in case management, appeals/denials, utilization review, quality improvement and clinical documentation improvement (CDI) positions, specifically in New York, New Jersey and Pennsylvania. The data analyzed in the survey is drawn from documented base salary data for hundreds of registered nurses in these specific non-bedside nursing positions.

2010 Registered Nurse Salary Survey Highlights:

“Average salary in 2009 for a non-clinical / non-bedside registered nurse in the New York Metro area was $83,592. This is trending upward as of the first quarter 2010.”

“More experience in non-clinical nursing does not always equate to a higher salary.”

“Registered nurse salaries in utilization review, quality improvement and appeals / denials all increased by more than 14% in 2009.”

“Director level salaries in non-clinical / non-bedside nursing were down 30% in 2009 and the trend appears to be continuing in 2010.”

“Non-clinical / non-bedside registered nurses with ‘work at home’ jobs earned an average of $68,000 per year.”

“Registered nurses with a higher level educational degree (BSN, MSN, PhD) earned up to 6.4% more than registered nurses with an associates degree or a diploma in nursing.”

“Registered nurses in non-clinical / non-bedside roles at hospitals earned an average of 5% more than their counterparts working for managed care organizations in 2009.”

Complete survey results will be released at the end of the month on the Pathway Medical Blog.

About Pathway Medical

Since 1998 Pathway Medical Staffing has specialized in recruiting non-bedside and non-clinical nursing professionals for full-time and temporary positions at leading healthcare organizations. To learn more about Pathway Medical Staffing visit www.pathway-medical.com.

A recent study conducted by Monster.com and the Human Capital Institute regarding employee attitudes and the global recession found that 79% of employees are “aggressively seeking work elsewhere.”  The study noted that 54% of employees have significantly increased their pursuit of new job opportunities and another 23% have stepped up their job search efforts in response to the current economy (1).

Pathway Medical Staffing, a nurse case management and non-clinical nurse recruiting firm, conducted an informal survey to see if these results held true for nurse case managers and other non-clinical nursing professionals. The results proved to be closely aligned with the broader employment study from Monster.com and the Human Capital Institute.

In December 2009 Pathway Medical Staffing surveyed 147 nurse case managers and non-clinical nursing professionals, representing nurses from 23 states (2).

The survey revealed that a whopping 57% of nurse case managers and non-clinical nursing professionals plan to look for a new job in 2010. Not surprisingly, the majority (53%) of nurse case managers indicated that they plan to look for a new job in order to increase their salary.

Click to Enlarge Image

However, there are several other areas that are causing these specialzed nurses to look for employment elsewhere.  Leading the reasons was 41% of respondents indicating that they were looking for a job that is more challenging, makes better use of their experience and / or finding a job that will help move to the next level of their career.  Closely following were 31% of respondents that indicated they were seeking new employment opportunities for better benefits than they currently have with their present employer.

Other motivators for finding a new job included: being closer to home (19% of respondents), better schedule (14% respondents) and plans to semi-retire and search for project or temporary work (5% respondents).

While most of the job market is still in a slump, there is good news for nurse case managers and non-clinical nurses that are searching for new jobs.  In a December 28, 2009 article, The Wall Street Journal reported that “Healthcare is expected to continue to see a surge in hiring with more than four million new openings estimated by 2018… [including] new specialties, particularly in case management (3).”

What can you do to kick start your Nursing Career in 2010?

If you’re considering making a job change you can start by exploring current job opportunities in nurse case management and non-clinical nursing to get a feel for what’s available.  You may be surprised by the range of open positions at some of the most respected healthcare organizations.

You can also sign up to receive email alerts for nurse case manager and non-clinical nursing jobs.  Alerts will immediately notify you when new jobs become available; giving you priority access to opportunities that meet your requirements

Don’t let  the stress of updating your resume and preparing for interviews keep you from exploring new case management opportunities. Companies like Pathway Medical Staffing help nurse case managers find jobs that match their experience and career goals and help job seekers write their resumes and prepare for interviewing.

If your new year resolutions are like most nurse case managers and non-clinical nursing professionals, get started with your job search today!  Don’t let 2010 go by with an unfulfilled resolution to give your nursing career a boost.

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Since 1998 Pathway Medical Staffing has placed hundreds of  nurse case managers and non-clinical nurses in great jobs at leading healthcare organizations.

Sources:

1. Monster.com and The Human Capital Institute.  “The Great Recession From the Worker Perspective.”  August 2009.
2. Pathway Medical Staffing.  “2010 Nurse Case Manager Career Resolutions.” January 2010.  Survey of 147 nurse case managers and non-clinical nurse managers regarding 2010 New Year resolutions for their nursing career. Survey conducted in December 2009.
3. Wall Street Journal. “Landing a Job in the Future Takes a Two-Track Mind. December 28, 2009.

According to a recent study from Monster.com and The Human Capital Institute, employers are out of touch with employee attitudes toward their jobs in light of the current recession.  The report notes that while only 20% of employers think that workers are looking for jobs elsewhere, the reality is that 79% of workers reported that they are aggressively pursuing jobs outside their current employer (1).

Pathway Medical Staffing, a nurse case management and non-clinical nursing recruiting firm, conducted an informal survey to understand if these results held true for nurse case managers and other nurse management professionals. The results proved to be closely aligned with the broader employment study from Monster.com and the Human Capital Institute.

In December 2009 Pathway Medical Staffing surveyed 147 nurse case managers and non-clinical nursing professionals to understand their new year career resolutions for 2010. The study represented nurses from 23 states in the U.S. with the majority (65%) from the New York Metro Area.

The survey revealed that a whopping 57% of nurse case managers and non-clinical nursing professionals plan to look for a new job in 2010.  Not surprisingly, the majority (53%) of respondents indicated that they plan to look for a new job to increase their salary.

Click to Enlarge Graph

However, there are several other areas that are causing nurse case managers and non-clinical nurses to look for employment elsewhere.  Forty-one percent (41% ) of respondents indicated that they are looking for a job that is more challenging or makes better use of their experience and will help advance their career.   Closely following, were 31% of respondents that are seeking new opportunities to gain better benefits than they have with their current employer.

Other motivators for finding a new job included: being closer to home (19% of respondents), better schedule (14% respondents) and plans to semi-retire and search for project or temporary work (5% respondents) (2).

These results may be disturbing to employers that hire nurse case managers and related nursing professionals, especially in light of a December 28, 2009 report from the The Wall Street Journal.  The WSJ article noted that “Healthcare is expected to continue to see a surge in hiring with more than four million new openings estimated by 2018… [including] new specialties, particularly in case management (3).” There will be more opportunities for case managers and non-clinical nurses to pursue their career goals elsewhere if these career goals are not met by their current employer.

While these statistics may be troubling to healthcare employers, there is an opportunity for employers to address nurse manager concerns.  Employers should keep in mind the reasons that nurse case managers and non-clinical nurses are looking for new opportunities. While employers may have limited to no control over salary, there are other benefits that may help retain this specialized nursing talent.

One career resolution noted by 63% of nursing professionals was to further their education.  Offering to cover expenses for continuing education may be enough incentive to retain top talent.  Other possible benefits to retain talent may be offering flexible hours, more vacation or telecommuting options.  Succession planning may also help top talent to understand their opportunities for advancement within the organization so that they see the possibility to move to the next level in their career without leaving the organization.  Some employees may simply feel that they are not challenged enough or their skills are being underutilized.  Healthcare organizations should pay close attention to star performers looking for new challenges.  Significant effort should be made to retain these employees, or they will surely be lost to one of the many healthcare organization that can provide what they are seeking.

New Opportunities for Healthcare Employers to Attract Top Talent

There is also an upside for healthcare employers in light of the significant number of nursing professionals searching for new jobs.  Given that the majority of nurse case managers and related nursing professionals are seeking more rewarding opportunities, now is the time to attract this top talent.  However, it is often difficult to identify these specialized nurses.  Not only do healthcare organizations need to make sure that job opportunities are in front of nurse case managers and non-clinical nursing professionals looking for a change, the jobs must also be enticing enough to appeal to the nurses’ career goals. Attracting this top talent can be quite a challenge if your organization does not have the resources to make a dedicated effort to the process.

If your organization is like most, you are pressed for resources to attract top talent. This challenge is especially difficult in recruiting nurse case managers an non-clinical nurses given that they are usually hard to find.

Pathway Medical Staffing specializes in the recruitment of nurse case managers and non-clinical nurses with access to thousands of these professionals carrying out confidential job searches.  Since 1998 the company has successfully placed these hard-to-find candidates at hundreds of leading healthcare organizations by keeping job opportunities in front of candidates on a regular basis.

If you are looking to attract top talent start your search for nurse case managers and non-clinical nursing professionals today.

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Since 1998 Pathway Medical Staffing has placed hundreds of nurse case managers and non-clinical nurses in great jobs at leading healthcare organizations.

Sources:

1. Monster.com and The Human Capital Institute.  “The Great Recession From the Worker Perspective.”  August 2009.
2. Pathway Medical Staffing.  “2010 Nurse Case Manager Career Resolutions.” January 2010.  Survey of 147 nurse case managers and non-clinical nurse managers regarding 2010 New Year resolutions for their nursing career. Survey conducted in December 2009.
3. Wall Street Journal. “Landing a Job in the Future Takes a Two-Track Mind. December 28, 2009.

Stories from Case Managers in Honor of Case Management Week…

I guess it started in the home care setting, when I worked in the  field as an infusion and home care nurse, moved on to a CHHA as a coordinator, and then moved to be a clinical manager and subsequently director of clinical services in a licensed and CHHA Agency.  

No matter what setting, home care is really case management with a different name. One focuses on assessing the patient and family needs, coordinating multiple services, and working collaboratively with clinical and insurance staff.   At my cancer care facility I came to Case Management when the program was restructured and started it’s Appeals and Denials program. Now, as the insurance Liaison Manager; I oversee the Patient Care advocacy program that advocates for patients who have complex needs that cannot be met within their local network; Manage the Inpatient Denials and Appeals program which maintains a reversal rate of 65-70%; and manage the administrative staff who are the liaisons with the insurance companies for the inpatient population.

Robin C –  RN, MPA
Insurance Liaison Manager