RN Full-time
Job Description

At Our Lady of Lourdes we offer you much more than just a job in the healthcare industry. We offer career opportunities for people who have a calling to share their gifts and talents as part of our healing ministry. As a Catholic hospital, we are here to create a spirit of healing - and we invite you to join our team today if you would like to be part of that spirit. In addition to competitive salaries and generous benefits, we offer you something special - the chance to do God's work by helping to serve people in need throughout our community, every day.

Job Summary: The Clinical Access Supervisor will be the preliminary step of the utilization management process and the access point for admissions. Ensures the coordination of patient care and resource utilization at the time of access to Lourdes. The Clinical Access Supervisor will have an understanding of CMS requirements and guidelines to facilitate appropriate admissions, as well as managed care contracts associated with Lourdes. Serves as a resource in the areas of direct admissions, emergency admissions, transfers from outside facilities, and elective surgery/procedure scheduling and functions as a liaison between admissions, surgery scheduling, physicians and Medical Management. The Clinical Access Supervisor also supervises and coordinates activities of departmental staff, participates in planning work of unit assignments and coordinates activities with other patient care units and related departments. Also Supports compliance with existing criteria and guidelines that ensure appropriate resource utilization.

Responsibilities

  • Clinical Access Review
  • Determines medical necessity and level of care guidelines using Interqual criteria for any questionable admission. 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.
  • Quality
  • Promotes the quality and efficiency of his/her own performance by remaining current with the latest trends in field of expertise through participation in job-relevant seminars and workshops, attendance at professional conferences, and affiliations with national and state professional organizations.
  • Collaboration and Partnership
  • Works closely with the acute Unit Supervisors. Utilizing information provided by the admitting physician, will notify the Unit Supervisors of any potentially difficult cases to ensure the coordination of discharge planning upon admission. Ensures the movement of patients through the continuum of care, enhance quality of care delivered, and control resource utilization.
  • Acts as a liaison between the physicians and Medical Management at the time of access. Under the direction of a Physician Advisor, the Clinical Access Coordinator will query the admitting physician for more information to determine medical necessity of the admission or the level of care desired. At the time of a questionable admission, the Clinical Access Coordinator will have the knowledge to direct the physician to an alternate level of care including skilled care, nursing home or outpatient services.
  • Leadership and Supervision
  • Assists in the effective hiring and training process for department staff.
  • Assigns and monitors staff work and work schedules according to department policy.
  • Maintains appropriate data on employee attendance for payroll/ATM.
  • Administers performance review process in a timely and effective manner.
  • Timely and effectively addresses employee relations issues.
  • Demonstrates ability to coach and mentor staff.
  • Facilitates patient throughput in the admission/discharge/transfer process.
  • Coordinates and communicates critical information related to risk issues, guest service issues or other need to know information with administration, risk management, medical management, medical staff, and patient advocates.
  • Other Duties
  • Performs other duties as assigned or requested.
  • Consistently performs 12 organizational Service Standards focused on Values, Service and Quality.

Qualifications

  • Bachelor's Degree
  • RN - Current/unrestricted RN license
  • BLS (Basic Life Support) Certification

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