RN, Registered Nurse Clinical Care Coordinator - CM Pre-Screening - Full Time
Company: Christus Health
Location: Texarkana
Posted on: October 23, 2024
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Job Description:
Description
Summary:
The Registered Nurse Clinical Care Coordinator is responsible for
evaluating, coordinating, processing, screening, and documentation
of patient entry into the CHRISTUS Health System. The Registered
Nurse Clinical Care Coordinator will collaborate with relevant
providers and partners to determine the appropriate patient class
and level of care of patients entering the CHRISTUS Health system
to ensure the appropriate utilization of resources and maximize
appropriate reimbursement opportunities. They will utilize
problem-solving and customer service skills to determine the best
course of action for the patient, the physician, and the hospital
by working closely with facility House Supervisors, referring
physicians, ED, and inpatient staff to ensure the effective and
efficient admission/placement of every patient. This role requires
the full understanding and active participation in fulfilling the
Mission of CHRISTUS Health. It is expected that the associate
demonstrates behavior consistent with the Core Values. The
associate shall support CHRISTUS Health's strategic plan and the
goals and direction of their Performance Improvement Plan
(PIP).
Responsibilities:
--- Meets expectations of the applicable OneCHRISTUS Competencies:
Leader of Self, Leader of Others, or Leader of Leaders. --- Reviews
clinical information for patients upon entry into the health system
to determine appropriate placement and patient class to maximize
appropriate hospital reimbursement and positively manage length of
stay. --- Coordinates with onsite partner providers (LTACH, Inpt
Rehab) to review requests for facility services and ensure
appropriate use of outpatient hospital resources for (their
patients) including scheduling coordination and appropriate escort
by sending provider. --- Review all ED patients identified by the
treating physician as requiring admission to the hospital to ensure
appropriate patient class and resource utilization. --- Educates
hospital and ED providers on levels of care, resource utilization,
payor practices, and documentation. Escalates to Physician Advisor
or CMO when discrepancies are present. --- Performs the initial
clinical medical necessity review utilizing evidence-based criteria
and enters into the medical record for the receiving CM team. ---
Provide after-hour and weekend support to the entire hospital from
a Care Management standpoint to include facilitating discharges
after business hours and responding to physician support needs and
inquiries. --- Review all post-surgical patients who are placed in
a bed to confirm appropriate patient class/admission status and
work with physicians to correct patient class when errors are
identified to maximize hospital reimbursement and resource
utilization. --- Responsible for 24/7 ongoing management of
patients in Observation status to include repeated review of
clinical and opportunities for conversion to inpatient status. ---
Works closely to coordinate and collaborate with the ED Case
Manager regarding patient class, discharge planning from ED, and
avoidance of readmissions. --- Ensures the details of incoming
communications from payors are entered into the medical record
(certifications, authorizations) and escalated when indicated
(receipt of denials, deadline for clinical receipt, etc.).
Requirements:
Education/Skills -
Experience -
Licenses, Registrations, or Certifications -
Work Schedule:
TBD
Work Type:
Full Time
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please contact us at (844) 257-6925.
Keywords: Christus Health, Shreveport , RN, Registered Nurse Clinical Care Coordinator - CM Pre-Screening - Full Time, Healthcare , Texarkana, Louisiana
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