Patient Flow RN

Job description

Employment Type: Full time Shift: Night Shift Description: GENERAL SUMMARY: The RN Patient Flow Coordinator is responsible for appropriately placing patients, based on diagnosis and physician preference, with consideration of bed availability and oversees the incoming calls of the One Call Center and working with protocols, triages and transfers those calls appropriately to facilitate the admission of patients to Mercy Medical Center. ESSENTIAL FUNCTIONS: · Monitors patient admissions to assure appropriate patient placement · Focuses on efficient bed utilization when assigning beds, based on patient diagnosis, special needs, physician preference and bed availability. · Conducts admission reviews per the UM plan related to level of care changes, to assure that hospitalization is warranted based on established criteria. · Utilizes knowledge of current census information and potential inpatient bed needs to project accurate and appropriate placement of incoming patients. · Oversees the incoming calls of the One Call Center and, working with protocols, triages and transfers those calls appropriately to facilitate the admission of patients to Mercy Medical Center. · Communicates bed placement explanations to appropriate Patient Flow and Patient Access Department staff. · Facilitates communication with respective Department Directors and managers regarding bed flow and other issues as appropriate. · Facilitates appropriate referrals to care coordination. · Occasionally assists with pre-authorization of services, as needed. · Utilizes expert knowledge and teamwork to facilitate cohesive efforts to achieve continuous quality management and excellence in providing for patients and/or populations. · Applies professional Nursing skills in applying the four aspects of the nursing process (assessment, planning, implementation and evaluation) when indicated to evaluate needs of incoming patient and the disease process to assess needs for bed placement and appropriate care. · Acts as a liaison between Doctors, offices, facilities and Mercy to facilitate the admission process. · Assists medical staff physicians with interpretation and compliance with external regulatory agencies and Medicare, Medicaid and third party payer requirements. · Carries out hospital programs and principles of utilization review in compliance with hospital policies and external regulatory agencies Peer Review Organization (PRO), The Joint Commission (TJC, and multiple payer defined criteria for eligibility. Validates medical necessity using Medicare guidelines. · Promotes proactive planning and direction for care management, patient placement, pending discharges/transfers and appropriate use of services. · Works closely with the House Supervisor to efficiently manage patient volumes and available resources MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED: · Possession of a current license as a registered nurse issued by the State of Iowa. · BSN or degree in healthcare related field preferred. · Two years clinical nursing experience required. · Experience in Patient Access, Admissions and Flow Operations, preferred. · Proof of completion of Mandatory Reporter – Child and/or Dependent Adult Abuse training within three (3) months of hire. · BLS certified by the end of the orientation period (approximately six (6) weeks). Acceptable credentialing bodies and certifications include American Heart Association Basic Life Support for Healthcare Providers. · Basic understanding of computer applications. · Knowledge of eligibility requirements for insurance coverage with respect to health care services: ambulatory, observation stays, surgical, acute care, subacute and continuum of care services. · Demonstrated ability to manage complex clinical situations related to patient placement. Ability to work and function independently exercising judgement to reach resolutions to issues related to patient placement. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.