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Clinical Access Nurse - Rn, Weekend, Olol Discharge Planning Utilization Review

Company

Franciscan Missionaries of Our Lady Health System
Address , Baton Rouge, 70808, La
Employment type FULL_TIME
Salary
Expires 2023-07-29
Posted at 11 months ago
Job Description
Job Title : Clinical Access Nurse - RN Job Summary :
  • The Clinical Access Nurse assists with the preliminary step of the utilization management process and serves as the access point for admissions. Is responsible for obtaining orders on all patients for appropriate status and level of care using InterQual criteria. Obtains precertifications and insurance verification on transfers from other facilities and works in conjunction with patient care services for proper bed utilization and assignment.
Minimum Requirements :
  • License - Current and unrestricted Louisiana RN license
  • Experience - 3 years in general or specialty nursing practice
  • Education - Diploma, Associate's Degree or Bachelor's Degree from accredited RN program
Job Function :
  • Quality and Compliance
    • Determines medical necessity and level of care guidelines using Interqual criteria for admissions. Has an understanding of specific criteria required for admission, concurrent stay and an understanding of level of care and criteria subsets within each level of care. Ensures the compliance of EMTALA/COBRA regulations as it applies to transfers from outside facilities.
    • Promotes the quality and efficiency of his/her own performance through participation in staff educational programs, approved continuing education courses, and specialized skill training programs.
  • Determines medical necessity and level of care guidelines using Interqual criteria for admissions. Has an understanding of specific criteria required for admission, concurrent stay and an understanding of level of care and criteria subsets within each level of care. Ensures the compliance of EMTALA/COBRA regulations as it applies to transfers from outside facilities.
  • Promotes the quality and efficiency of his/her own performance through participation in staff educational programs, approved continuing education courses, and specialized skill training programs.
  • Collaboration and Partnership
    • Works closely with the acute Clinical Resource Coordinators utilizing information provided by the admitting physician to notify of any potentially difficult cases to ensure coordination of discharge planning upon admission.
    • Queries the admitting physician for more information to determine medical necessity of the admission or appropriate level of care. The Access nurse will have the knowledge to direct the physician to an alternative level of care including skilled care, nursing home or outpatient services
    • Coordinates appropriate bed placement in conjunction with Patient Care Services and the Bed Coordinator.
  • Works closely with the acute Clinical Resource Coordinators utilizing information provided by the admitting physician to notify of any potentially difficult cases to ensure coordination of discharge planning upon admission.
  • Coordinates appropriate bed placement in conjunction with Patient Care Services and the Bed Coordinator.
  • Queries the admitting physician for more information to determine medical necessity of the admission or appropriate level of care. The Access nurse will have the knowledge to direct the physician to an alternative level of care including skilled care, nursing home or outpatient services
  • Other Duties As Assigned
    • Performs other duties as assigned or requested.
  • Performs other duties as assigned or requested.