Bachelor's Degree - Nursing
3+ years of experience
- Job Summary
- Ensures effective and efficient operations of all functions of the Patient Placement area. Ensures quality service to all internal and external customers. Directs, coordinates, organizes and schedules all operational personnel within the Patient Placement area. Coaches and mentors staff providing opportunity for development and feedback. Ensures that all hospital and departmental policies and procedures are enforced.
The Admission Review Nurse Manager maintains a good working knowledge of the Patient Placement systems and processes and is responsible for implementation of computer hardware and software in the area ie (HEV, Epic).The Admission Review Nurse Manager will function as a process evaluator, is responsible for general training for the area, and is a resource for the Admission Review Nurses and the Patient Placement Coordinators in working through difficult and/or unusual issues which arise on a daily basis. Will collect data, performs audit trends, reports on admissions, and develops plans to improve daily processes.
The Admissions Review Nurse Manager is responsible for employee evaluations and in evaluating the effectiveness of new processes that are put into place. The Admission Review Nurse Manager serves on assigned committees and reports information to Director, staff, and other various Departments throughout the hospital. The Admissions Review Nurse Manager will evaluate pre-entry admissions to ensure correct patient status is obtained and screens all patients with bed requests (Direct Admits, scheduled Admissions and Emergency Room, CVCC) to determine, through the use of clinical indicators, the patient’s severity of illness and the intensity of services required and compares these to the services being requested for appropriate admission status and level of care; while maintaining an awareness of resources, reimbursement and legal regulations from payor requirements (i.e, Medicare, Medicaid, Managed Care and Insurance companies)
- Demonstrates population-specific competencies (e.g. age-specific, cultural sensitivity, patient-centered communication) in performance of role.
- Qualifications Required
- RN Licensure in Georgia required. Case Management certification preferred.
- Three years progressive experience required. Two of the three must be as a nurse in an acute/critical care. Previous experience must have demonstrated knowledge of the health care industry, specifically the functions of access service (outpatient registration or admission process), patient accounts or healthcare reimbursement. Knowledge of coding guidelines a plus. Utilization review or discharge planning preferred. Knowledge of Interqual guidelines and training required.
- Knowledge, skills, abilities:
- Demonstrated ability to assess health care needs of patients of specific age groups (neonate, infant, child, and adolescent, adult, geriatric).
- Demonstrated expertise in team management, problem solving, critical thinking, and data management.
- Strong analytical skills necessary to identify trends, practice pattern differences, applicability of research findings, clinical inferences, and financial issues.
- Must be able to analyze data generated from various clinical and financial computer software programs.
- Knowledge of medical literature, research methodology, health care delivery systems, financial/reimbursement issues and Medical Staff organizations.
- Excellent written and verbal communication skills.
- Ability to influence decisions, gain cooperation, and facilitate change with physicians, all levels of management, third party payers, other health care providers, patients, families, other hospital departments, etc. on a continual basis.
- Must be flexible and willing to work various shifts when needed to cover area 24/7.
- Demonstrated organizational and project management skills.
- Ability to collaborate with other departments and medical staff.
- Physical Demands
- Visual ability to read document, computer terminals
- Verbal communication skills to speak with staff, patients, visitors, and medical staff
- Auditory ability to hear staff, visitors, families, and medical staff via phone and in person
- Manual dexterity to use a PC and software packages, pens, pencils, etc.
- Ability to move about the organization, campus, and to travel to meetings
- Cognitive ability to understand and analyze complex health care information and data.
University Health Care System - 12 months ago