Experience:
3-5 years of experience
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Employment Type:
Full time
Posted:
7/22/2017
Job Category:
Nursing
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RN Care Management (Per Diem) Job
PeaceHealth | Springfield, Oregon
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Job Description

Req ID: 147980

PeaceHealth is seeking a relief Provider based in the Springfield, OR community. 

JOB SUMMARY

Coordinates and facilitates the discharge plan of care and service of selected patient populations across the continuum of illness, promote effective utilization and monitoring of health care resources, and assumes a leadership role with the interdisciplinary team to achieve optimal clinical, financial, and satisfaction of outcomes. Acts as intermediary between hospital and third-party payors to ensure patients receive appropriate medical services, and the organization receives appropriate and optimal reimbursement, in accordance with regulatory standards.

ESSENTIAL FUNCTIONS

  1. Reviews patient admission data within established timeframes of department, to determine the appropriate level of care in accordance with hospital-sanctioned industry standard criteria and/or other established criteria for other settings across the continuum of care.
  2. Assesses, develops, implements and monitors a comprehensive discharge plan of care through an interdisciplinary team process in conjunction with the patient and family in internal and external settings.
  3. Comprehensively assesses patients’ goals as well as their biophysical, psychosocial, environmental and discharge planning needs and financial status.
  4. Identifies key problems, strengths and resources to be addressed in the discharge plan of care, including needed resources post-discharge.  Coordinates and facilitates those services.
  5. Ensures accurate documentation for patient’s continued hospital stay is established and maintained, coordinates necessary changes with attending physician and other team members as necessary to achieve optimal care and reimbursement.
  6. Communicates proactively and adeptly with members of the interdisciplinary team to ensure hospital and community resources are appropriately and effectively utilized on behalf of patients and their families.
  7. Facilitates interdisciplinary team meetings to improve quality, decrease cost and improve patient satisfaction.
  8. Coordinates documentation and clarifies necessary details with Patient Financial Services to assist in decreasing denials.
  9. Ensures the completion of documentation necessary for utilization assessments and communicates via electronic medical record information needed to justify continued hospitalization.  Maintains any applicable care management databases.
  10. Performs concurrent review to determine correct admission status per insurance criteria, including Interqual or other industry standard criteria recognized by Medicare. Monitors and documents variance days, communicates with attending physician and UR Physician Advisor as indicated.  Documents outcomes in appropriate locations.
  11. Communicates within designated time frames with third party payers in order to obtain authorizations and resolve payment issues on behalf of patients and families and the organization if applicable.
  12. May assume Palliative Care responsibilities as indicated, including facilitate and coordinate – pain and symptom management, POLST, family meetings, comfort care.
  13. Performs other duties as assigned.

QUALIFICATIONS - Required Unless Otherwise Stated

EDUCATION:

  • Graduate of an accredited school of nursing
  • BSN or MSN preferred.

EXPERIENCE/TRAINING:

  • Minimum of three years of clinical nursing experience in an acute care hospital.
  • Equivalent skilled nursing facility, outpatient case management, home health or hospice experience may be considered
  • Utilization management/quality management experience preferred.
  • Third party reimbursement knowledge preferred.

LICENSE/CERTIFICATION:

  • Current Registered Nurse licensure in the state in which nurse will be practicing.
  • Current BLS (Basic Life Support) certification required at date of hire.
  • Specialty Certification preferred.

KNOWLEDGE/SKILLS/ABILITIES:

  • Interpersonal skills to obtain and interpret information appropriate to patients’ needs and age as required for assessment range of treatment, and patient care.
  • Skill and proficiency in applying highly technical principles, concepts, and techniques.  Such proficiency is usually acquired through completion of a bachelor’s degree in nursing; any equivalent combination of education, training, and/or experience that fulfills the requirements of the position will be considered.
  • Demonstrated ability to promote positive interpersonal relationships and patient/family centered work environment.
  • Basic computer skills including MS Office applications
  • Effective prioritization skills

RIVERBEND PHYSICAL/COGNITIVE REQUIREMENTS:

  • Work requires normal amounts of physical effort at least 66% of the time.
  • Ability to lift objects weighing 30 lbs. or less.        
  • Work is performed under normal working conditions with adequate lighting and ventilation.        
  • Job duties frequently require intense concentration and attention to detail (34-65% of work time).

If you are interested in this career opportunity, please contact Jennifer Foster.

360-729-2403

jfoster3@peacehealth.org

About PeaceHealth

PeaceHealth, based in Vancouver, WA, is a not-for-profit Catholic health system offering care to communities in Washington, Oregon, and Alaska. PeaceHealth has approximately 16,000 caregivers, a multi-specialty medical group practice with more than 800 physicians and providers, a comprehensive laboratory system, and ten medical centers serving both urban and rural communities throughout the Northwest. In 1890, Sisters of St. Joseph of Peace founded what has become PeaceHealth. Today, PeaceHealth is the legacy of its founding Sisters and continues to serve communities when invited to do so with a spirit of collaboration and stewardship – the spirit of health.

To learn more about working at PeaceHealth and the Springfield, OR community, along with our benefits offered, please visit our homepage www.peacehealth.org/careers.

Get a feeling for the Spirit of PeaceHealth through this three-minute video, and visit us on Facebook or LinkedIn!

PeaceHealth is committed to providing equal employment opportunities to all qualified job applicants and employees without regard to the following statuses: protected veteran; qualified individual with a disability; race; ethnicity; religion; gender; pregnancy; gender identity; national origin; age; genetic information; sexual orientation; or any other protected status in accordance with local, state, or federal laws.

Location: Springfield, OR, SHMC at Riverbend (420)
Job CategoryNursing - RN Other
Shift:  Day
FTE:  0.0 
Work Type:  Per Diem/Relief

The above information is intended to indicate the general nature and level of work performed by this position. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of caregivers assigned to this job.

Posting Notes: Springfield, OR || Nursing - RN Other || Per Diem/Relief || CLINICAL SUPP SVCS

About PeaceHealth

PeaceHealth is a not-for-profit health care system sponsored by the Sisters of St. Joseph of Peace, with services in Washington, Oregon and Alaska. PeaceHealth's rigorous pursuit of exceptional medicine springs from its mission, values, and commitment to provide healing and compassionate care to patients and families.

This company profile was created by AfterCollege and is about PeaceHealth. This page is not endorsed by or affiliated with PeaceHealth. For questions regarding company profiles, please email: care@aftercollege.com.