Qureos Mentor

Children's National Hospital

<div>
 This position reports to the Clinic Operations Supervisor or Clinic Operations/Practice Manager. Provide patient services and administrative support in clinic operations. Interacts with parents, patients, physicians and other staff under moderate supervision in a courteous manner. Provide assistance to other employees within their department as well as other departments. Collect and verify all demographic information to ensure accuracy . May provide required notification of scheduled services according to managed care requirements. May be responsible for scheduling patients for specialty appointments. Position may be required to float to other clinics or ROCs for coverage. Next step in career ladder is Senior Clinic Operations Rep or Team Lead position.
 
 
 
 Minimum Education
 
 
 
 High School Diploma or GED (Required)
 
 
 
 Minimum Work Experience
 
 
 
 1 year Experience performing billing, patient registration, and scheduling, medical insurance verification, insurance screening. (Required)
 
 
 
 Required Skills/Knowledge
 
 
 
 Broad clinic knowledge, customer service skills. Computer knowledge necessary. Microsoft Office experience preferred (Word &amp; Excel). Complete Ambulatory Services training curriculum and pass all competency assessments, including a mock clinic. The ability to type minimum of 35 words per minute required.
 
 
 
 Functional Accountabilities
 
 
 
 
 Patient Services
 
 
 
 <ul>
 <li>
 Demonstrate accuracy of scheduling patients using the applicable scheduling system for the department.
 </li>
 <li>
 Complete computer aided, on-line registration screen with parent/guardian via telephone or in person in professional &amp; courteous manner.
 </li>
 <li>
 Collect accurate demographic and insurance information. Update systems as needed in accordance with department standards for registration accuracy .
 </li>
 <li>
 Reschedule appointment for patients who did not show or for the ancillary services cancellations by providers/technologist. Schedule follow up appointments at check out if applicable.
 </li>
 <li>
 Greet patients and parents courteously. Arrive patient in appropriate system based on department policy .
 </li>
 <li>
 Obtain required consents for department &amp; ensure distribution of compliance related materials (i.e. HIPPA Privacy Notice, Patient Rights).
 </li>
 <li>
 Obtain copy of insurance card and photo ID to be stored in medical record (copy or scan activity required). Ensure applicable insurance company and CNMC HIM department receive copies of appropriate forms/documentation. Complete all documentation in accordance with department policy and procedure.
 </li>
 <li>
 Respond to patient portal work lists (i.e. appointment requests, fax queues, email requests, etc. May include messaging center work lists in the future).
 
 
 </li>
 </ul>
 
 Information Verification
 
 
 
 <ul>
 <li>
 Verify insurance eligibility using applicable eligibility system. Ensure managed care carve outs (lab and radiology carve outs) are adhered to.
 </li>
 <li>
 Notify parents of the need for completed insurance referral form or pre-authorization prior to scheduled/unscheduled appointments.
 </li>
 <li>
 Discuss co-payment, deposits, payment in full, or past due balance collections with parents prior to scheduled appointment in a professional &amp; courteous manner.
 </li>
 <li>
 Counsel parents or refer parent to Financial Information Center (FIC) for establishing payment schedule or method of payment.
 </li>
 <li>
 Verify insurance information is complete prior to procedure and collect and verify pre-authorization/referral information: goal is to obtain authorizations 5 days in advance of service.
 </li>
 <li>
 Utilize all systems where patient information may be stored (EPRS, SCI, Cerner, IDX, McKesson, etc.) to verify that systems are in sync
 
 
 </li>
 </ul>
 
 Cash Collection
 
 
 
 <ul>
 <li>
 Collect and record co-payments, deposits and payments in full and provide payer with receipt. Responsible for helping department meet 85% of the collection target for the department.
 </li>
 <li>
 Maintain departmental requirements regarding cash controls and collections.
 
 
 </li>
 </ul>
 
 Billing Preparation
 
 
 
 <ul>
 <li>
 Reconcile schedules for upcoming clinic session to include ensuring that accounts are set up for billing and services requiring authorization are flagged: Activity should be completed 3-4 days in advance of clinic session; Areas with procedures requiring authorizations work standard may be 5-7 days.
 </li>
 <li>
 Appropriately clear all walk-in and ensure scheduled/unscheduled appointments are linked to scheduling system.
 
 
 </li>
 </ul>
 
 Office Support
 
 
 
 <ul>
 <li>
 Answer telephone and address caller needs appropriately. Avoid transferring calls for better service to families. Meet department standards relative to ACD policies if applicable. Manage voice mail messages within same business day .
 </li>
 <li>
 Distribute mail. May work returned mail as needed.
 </li>
 <li>
 All staff are responsible for information distributed via e-mail. Staff should check work email a minimum of 3 times daily and respond to inquiries within 24 hours (or next business day).
 </li>
 <li>
 Maintain office files and office supplies at P AR levels.
 </li>
 <li>
 Maintain clean reception area and work space.
 </li>
 <li>
 Other support as needed.
 
 
 </li>
 </ul>
 
 Safety
 
 
 
 <ul>
 <li>
 Speak up when team members appear to exhibit unsafe behavior or performance
 </li>
 <li>
 Continuously validate and verify information needed for decision making or documentation
 </li>
 <li>
 Stop in the face of uncertainty and takes time to resolve the situation
 </li>
 <li>
 Demonstrate accurate, clear and timely verbal and written communication
 </li>
 <li>
 Actively promote safety for patients, families, visitors and co-workers
 </li>
 <li>
 Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
 
 
 </li>
 </ul>
 
 Organizational Accountabilities
 
 
 
 
 Organizational Accountabilities (Staff)
 
 
 Organizational Commitment/Identification
 
 
 
 <ul>
 <li>
 Anticipate and responds to customer needs; follows up until needs are met
 
 
 </li>
 </ul>
 Teamwork/Communication
 
 
 <ul>
 <li>
 Demonstrate collaborative and respectful behavior
 </li>
 <li>
 Partner with all team members to achieve goals
 </li>
 <li>
 Receptive to others&rsquo; ideas and opinions
 
 
 </li>
 </ul>
 Performance Improvement/Problem-solving
 
 
 <ul>
 <li>
 Contribute to a positive work environment
 </li>
 <li>
 Demonstrate flexibility and willingness to change
 </li>
 <li>
 Identify opportunities to improve clinical and administrative processes
 </li>
 <li>
 Make appropriate decisions, using sound judgment
 
 
 </li>
 </ul>
 Cost Management/Financial Responsibility
 
 
 <ul>
 <li>
 Use resources efficiently
 </li>
 <li>
 Search for less costly ways of doing things
 
 
 </li>
 </ul>
 Safety
 
 
 <ul>
 <li>
 Speak up when team members appear to exhibit unsafe behavior or performance
 </li>
 <li>
 Continuously validate and verify information needed for decision making or documentation
 </li>
 <li>
 Stop in the face of uncertainty and takes time to resolve the situation
 </li>
 <li>
 Demonstrate accurate, clear and timely verbal and written communication
 </li>
 <li>
 Actively promote safety for patients, families, visitors and co-workers
 </li>
 <li>
 Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
 
 
 </li>
 </ul>
 
 Primary Location
 
 
 
 District of Columbia-Washington
 
 
 
 Work Locations
 
 
 
 CN Hospital (Main Campus)
 
 
 
 Job
 
 
 
 Administrative Support / Customer Service
 
 
 
 Organization
 
 
 
 Ambulatory
 
 
 
 Position Status
 
 
 
 R (Regular)
 
 
 
 Shift
 
 
 
 Day
 
 
 
 Work Schedule
 
 
 
 8:30am-5:00pm
 
 
 
 Job Posting
 
 
 
 Sep 16, 2025, 9:30:00 AM
 
 
 
 Full-Time Salary Range
 
 
 
 43160
</div>

Clinic Operations Rep

<div></div><div><div>Description<div></div> 
All nursing practice is based on the legal scope of practice, national and specialty nursing standards, Children's National Policies and Procedures, andin accordance with all applicable laws and regulations. The Professional Model of Care requires registered professional nurses to be responsible and accountable for their own practice. Children's National supports the development of RN relationships within the community; specifically those 
relationships associated with the health and well being of the community at large.
This position may float to other locations (RN License required in Maryland and District of Columbia). Hours will vary between 7:30am to 5pm on weekdays.<div> 
</div></div><div>
Qualifications<div></div> 
Minimum Education 
BSN Graduated from an approved school of nursing. (Preferred) 
 
Minimum Work Experience 
1 year of RN experience (Required) 
 
Required Skills/Knowledge 
The licensed Registered Nurse will successfully complete the hospital and nursing orientation at Children&rsquo;s National. 
Keep knowledge base current with new information or changes in specialty area. 
 
Required Licenses and Certifications 
Registered Nurse in District of Columbia (Required)
Registered Nurse licensed in the District of Columbia, Maryland or Virginia dependent upon location of practice. (Required)
Cardio-Pulmonary Resuscitation (CPR) (Required) 
 
Functional Accountabilities: 
Transformational Leadership<ul><li>
Contribute to Magnet re-designation as evidenced by independent updating of professional profile and initiation of council involvement, committees, task forces and /or community outreach.</li></ul><ul><li>
Demonstrate critical thinking skills by problem solving appropriately during patient care.</li></ul><ul><li>
Communicate to reflect development of plan of care and ability to advocate to meet patients&rsquo; needs.</li></ul><ul><li>
Independently initiate escalation of issues utilizing chain of command.</li></ul><ul><li>
Demonstrate proper use of the currently identified hand off processes.</li></ul><ul><li>
Demonstrate a collegial and respectful relationship with ancillary staff.</li></ul><ul><li>
Participate in implementing change and support management decisions.</li></ul><ul><li>
Role model behavior that reflects empathy, concern and a desire to help others.</li></ul>
Structural Empowerment<ul><li>
Independently maintain regulatory requirements e.g. license, BLS.</li></ul><ul><li>
Plan for attendance at mandatory education and professional activities to enhance nursing practice.</li></ul><ul><li>
Demonstrate professional review of peers through timely participation in evaluations.</li></ul><ul><li>
Seek out opportunities to participate in enhancing departmental goals by ensuring adherence to national safety standards and service excellence standards; support advancement of education and certification as well.</li></ul><ul><li>
Collaborate with members of the healthcare team and role model professional behavior and teamwork with coworkers.</li></ul><ul><li>
Utilize resources as needed and know when to escalate to next level.</li></ul>
Exemplary Professional Practice<ul><li>
Utilize assessment data gathered from patient and family to ensure completion of data base and plan of care within identified timeframes.</li></ul><ul><li>
Demonstrate clinical skills with complex patients that reflect analysis of patient status and appropriate interventions.</li></ul><ul><li>
Role model skill in prioritization and organization for complex patient with rapidly changing needs.</li></ul><ul><li>
Documentation exemplifies adherence to the highest standards of practice.</li></ul><ul><li>
Anticipate and proactively plan for educational needs verified with patient and family throughout the hospital/outpatient stay and prior to discharge.</li></ul><ul><li>
Role model organizational skills, adjust for changes and is able to complete assignment on time.</li></ul><ul><li>
Demonstrate caring in all encounters with patient and family as evidenced by feedback from parents and an increase in patient satisfaction scores.</li></ul>
Safety<ul><li>
Speak up when team members appear to exhibit unsafe behavior or performance</li></ul><ul><li>
Continuously validate and verify information needed for decision making or documentation</li></ul><ul><li>
Stop in the face of uncertainty and takes time to resolve the situation</li></ul><ul><li>
Demonstrate accurate, clear and timely verbal and written communication</li></ul><ul><li>
Actively promote safety for patients, families, visitors and co-workers</li></ul><ul><li>
Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance</li></ul> 
Organizational Accountabilities: 
New Knowledge, Innovations, and Improvements<ul><li>
Identify ways to improve operations through quality improvement and assist in implementation of solutions.</li></ul><ul><li>
Identify self learning needs and take initiative to meet those needs.</li></ul><ul><li>
Ensure care is based on evidence with the literature and benchmarking</li></ul>
Organizational Commitment/Identification<ul><li>
Partner in the mission and upholds the core principles of the organization</li></ul><ul><li>
Committed to diversity and recognizes value of cultural ethnic differences</li></ul><ul><li>
Demonstrate personal and professional integrity</li></ul><ul><li>
Maintain confidentiality at all times</li></ul>
Customer Service<ul><li>
Anticipate and responds to customer needs; follows up until needs are met</li></ul>
Teamwork/Communication<ul><li>
Demonstrate collaborative and respectful behavior</li></ul><ul><li>
Partner with all team members to achieve goals</li></ul><ul><li>
Receptive to others&rsquo; ideas and opinions</li></ul>
Performance Improvement/Problem-solving<ul><li>
Contribute to a positive work environment</li></ul><ul><li>
Demonstrate flexibility and willingness to change</li></ul><ul><li>
Identify opportunities to improve clinical and administrative processes</li></ul><ul><li>
Make appropriate decisions, using sound judgment</li></ul>
Cost Management/Financial Responsibility<ul><li>
Use resources efficiently</li></ul><ul><li>
Search for less costly ways of doing things</li></ul><div>
</div></div><div>
Primary Location: Maryland-Annapolis</div><div>
Work Locations: Annapolis 1730 West St 1st Floor Suite 100 Annapolis 21401</div><div>
Job: Nursing</div><div>
Organization: Ambulatory</div><div>
Position Status: R (Regular) - PT - Part-Time</div><div>
Shift: Day</div><div>
Work Schedule: varying weekdays Monday-Friday</div><div>
Job Posting: Sep 10, 2025, 9:43:34 AM</div><div>
Full-Time Salary Range: 68806.4 - 125174.4</div></div>

Registered Nurse II - Ambulatory

<div></div><div><div>Description<div>
</div>
The purpose of the Ambulatory Nurse Case Managers is to comprehensively and actively manage the care management and coordination needs of payer defined and/or payer enrolled populations or patients who meet designated inclusion criteria. This includes activities such as assessments, formal Case Management care plan development, establishing goals and intervention and monitoring/tracking. Through these activities, the Ambulatory Nurse Case Manager will partner with physician practices and the care management team related to the clinical and care coordination needs of the patient, as well as work with payers and/or community resources to develop and facilitate effective, efficient care delivery options for the identified at risk patients across the care continuum.<div>
</div></div><div>
Qualifications<div>
</div>
Minimum Education 
BSN (Required) 
Master's Degree (Preferred) 
 
Minimum Work Experience 
4 years Nursing experience in case management, ambulatory nursing or community/homecare experience preferred (Required) 
 
Required Skills/Knowledge 
Ability to critically think and apply logic and reasoning to dynamically changing healthcare environment. 
Requires superior verbal communication skills and service excellence approach with internal and external stakeholders. 
Must have strong business writing skills. 
Proficient at keyboarding and facile with Microsoft Office Excel, Access and Power Point. 
 
Required Licenses and Certifications 
Registered Nurse in District of Columbia (Required) 
Licensed RN (Required) 
Certification in Case Management preferred (Preferred) 
 
Functional Accountabilities 
Ambulatory Case Management 
<ul><li>
Provides intensive case management and care coordinationfor higher risk sub-populations defined by federal and third party payers or through case finding and referrals that meet inclusion criteria
</li></ul><ul><li>Develops and documents comprehensive care plans with clinician and family identified goals
</li></ul><ul><li>Assesses and monitors patient&rsquo;s progress on care goals, regularly interfacing with care team and refining the care plan as indicated
</li></ul><ul><li>Identifies barriers to attaining goals within care plan and mobilizes resources to mitigate barriers
</li></ul><ul><li>Supports family self-management and patient advocacy through education and communication
</li></ul>Collaboration with Medical Home and Care Management Team 
<ul><li>
Coordinates and collaborates with physicians and other providers to facilitate provision of effective, efficient services to meet the patient&rsquo;s complex needs
</li></ul><ul><li>Maintains care plans in coordination with practices/care delivery system and case management team members
</li></ul><ul><li>Collaborates with clinical care team as well as case management care team to define interventions to meet the patient's care management needs and any population health goals
</li></ul><ul><li>Delegates and supervises care management activities to non-nursing team members in accordance with the DC Nurse Practice Act.
</li></ul><ul><li>Provides or organizes relevant patient education and health coaching, condition-specific as applicable
</li></ul>Transitions of Care 
<ul><li>
Accepts and facilitates bi-directional Care Transition hand-offs to follow-up of enrolled patients after ED visit, Urgent Care, Observation, Inpatient, SNF stay and transitions to adolescent and adult providers</li></ul><ul><li>
Works with payers, acute and post-acute care providers/care managers and/or community resources to develop and facilitate effective, efficient, sustainable care delivery options across settings.</li></ul><ul><li>
Communicates patient care plan and needs to new care teams as patient transitions to different care settings across the continuum.</li></ul><ul><li>
Guides and support a smooth transition from pediatric to adult care &amp; providers Decide if want separate bulltet point or include in first one</li></ul>
Documentation and Data Management 
<ul><li>
Documents patient consent for case management and care coordination as required
</li></ul><ul><li>Documents the plan of care, reviews at designated intervals and updates as needed; shares with physician and patient caretaker
</li></ul><ul><li>Leverages IT systems to capture data; submit claims for care managementas needed
</li></ul><ul><li>Monitors data reports and registries to case find patients in need of outreach and/or case management interventions and care coordination
</li></ul><ul><li>Reviews data outcomes for patient caseload to identify clinical, quality and/or financial metrics that require attention and intervention.
</li></ul> 
Organizational Accountabilities 
Organizational Accountabilities (Staff) 
Organizational Commitment/Identification
<ul><li>Anticipate and responds to customer needs; follows up until needs are met</li></ul> 
Teamwork/Communication
<ul><li>Demonstrate collaborative and respectful behavior</li></ul><ul><li>
Partner with all team members to achieve goals</li></ul><ul><li>
Receptive to others&rsquo; ideas and opinions</li></ul> 
Performance Improvement/Problem-solving
<ul><li>Contribute to a positive work environment</li></ul><ul><li>
Demonstrate flexibility and willingness to change</li></ul><ul><li>
Identify opportunities to improve clinical and administrative processes</li></ul><ul><li>
Make appropriate decisions, using sound judgment</li></ul> 
Cost Management/Financial Responsibility
<ul><li>Use resources efficiently</li></ul><ul><li>
Search for less costly ways of doing things</li></ul> 
Safety
<ul><li>Speak up when team members appear to exhibit unsafe behavior or performance</li></ul><ul><li>
Continuously validate and verify information needed for decision making or documentation</li></ul><ul><li>
Stop in the face of uncertainty and takes time to resolve the situation</li></ul><ul><li>
Demonstrate accurate, clear and timely verbal and written communication</li></ul><ul><li>
Actively promote safety for patients, families, visitors and co-workers</li></ul><ul><li>
Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance</li></ul><div>
</div></div><div>
Primary Location: District of Columbia-Washington</div><div>
Work Locations: CN Hospital (Main Campus) 111 Michigan Avenue NW Washington 20010</div><div>
Job: Nursing</div><div>
Organization: Patient Services</div><div>
Position Status: R (Regular) - FT - Full-Time</div><div>
Shift: Day</div><div>
Work Schedule: 0830-1700</div><div>
Job Posting: Sep 10, 2025, 9:46:46 AM</div><div>
Full-Time Salary Range: 82347.2 - 137238.4</div></div>

Ambulatory Nurse Case Mgr

Join Children's National Hospital and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Children's National Hospital

ABOUT_COMPANY

Clinic Operations Rep

Registered Nurse II - Ambulatory

Ambulatory Nurse Case Mgr