Inpatient Care Coordinator HOT JOB

SouthEast Alaska Regional Health Consortium Sitka, AK, US

$41.66 - $58.69 / hour

Pay Range:

Pay Range:$41.66 - $58.69 ***********************************************************

$25K Sign On and $10K Relocation for qualified hire!

***********************************************************

Manages patient progression of care, promote evidenced-based protocols, ensure the appropriateness of interventions, and expedite care delivery for patients admitted. Directs patient care services to ensure a timely and appropriate patient discharge.

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more.

Key Essential Functions and Accountabilities of the Job

Reviews patients’ records and evaluates patient progress.
- Performs continuing review of the patient hospitalization to specifically monitor the necessity for and appropriateness of hospitalization, length of stay, and quality of care.
  - Provides these UM and review functions to the Purchased/Referred Care Services program for SEARHC beneficiary patients admitted to other facilities.
- Obtains and reviews necessary medical reports and treatment plans as requested by regulatory agencies or payers.
- Reviews and validates physician orders, reports progress and unusual occurrences on patients.
- Works with the MEH leadership, clinical care team and physicians to ensure healthcare services are appropriate and cost-effective.

Collaborates with physicians, MEH leadership, and the clinical care team to ensure adherence to the UM/CM/DCP plan.
- Reviews new hospital admissions to assess patient condition(s) and needs in order to develop personalized treatment plans.
- Provides appropriate or required information to patients and/or their families regarding their healthcare benefits.
- Reviews patient records and participate in interdisciplinary collaboration with professional staff.
- Ensures maintenance of the Utilization Review Plan collaboration with the Utilization review staff Medical Director (or designated provider).
- Facilitates educational programs and advises physicians and other departments of regulations affecting UM/CM/DCP.
- Directs the coordination of patient care departments, ensuring treatment plans are based on the need of the patient and meet criteria approved by the hospital and any regulatory or payer requirements.

Ensures documentation supports the UM functions and communicates with payers within required timeframes.
- Reviews information, communicates results to claims adjusters, and enters billing information appropriate.
- Prepares information for notification letters providers, staff, and patients.
- Received and processes request for appeal of denials.
- Responds to complaints per UM review guidelines.
- Maintains utilization review and appeal logs.

Supports clinical improvements activates of SEARHC by providing quality review.
Performs tumor registry functions for SEARHC.

Other Functions

Other duties as assigned.

Supervisory Responsibilities

This position does not require supervisory responsibilities.

Education, Certifications, and Licenses Required

Associates Degree in Nursing required, Bachelor's Degree preferred
Case Management certification by recognized certifying organization (i.e., NCQA, CCMC) preferred can obtain within 24 months of hire.
Active nursing license in Alaska or other U.S. state required.
Direct Hire must have applied for an Alaska nursing license at time of hire. Agency staff must have an active Alaska license.
Basic Life Support
High school diploma or equivalent required.
Clinical Competency required within 3 months of hire and every three years

Experience Required

8 years’ clinical care or nursing experience, 3 years of which should be in chart review, risk management, or related quality service

Knowledge of

Conducting and reviewing medical records for medical necessity, level of care, and public and private insurance reimbursement.
Basic ICD-9 and CPT coding.
Regulations as set forth by The Centers for Medicare Medicaid Services.
Proficient in medical terminology, anatomy, physiology, and concepts of disease.

Skills in

Providing effective nursing care, assessing patient situations and taking effective courses of action.
Strong written and oral communication skills.
Strong organizational skills.

Ability to

Ability to communicate and collaborate effectively with providers, staff, and patients.

Physical Demands:

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk; sit; use hands to finger, handle or feel and reach with hands and arms.
The employee is occasionally required to climb or balance; stoop, kneel, crouch or crawl. The employee must lift and/or move 50 lbs.

Required Certifications:

Basic Life Support (BLS) - American Heart Association, Clinical Competency Assessment - SEARHC, Registered Nurse License - State of Alaska - Alaska State Board of Nursing

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

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SouthEast Alaska Regional Health Consortium Sitka, AK

$44.57 - $62.80 / hour

Pay Range: Pay Range:$44.57 - $62.80 *********************************************************** $25K Sign On and $10K Relocation for qualified hire! *********************************************************** The registered nurse coordinates and performs a variety of nursing care procedures for patients of all ages, requiring professional knowledge and consideration of specific patient conditions and treatments; and the ability to work independently in completing assignments. Guidelines include provider’s orders; standards of care, nursing policies and procedures manuals, hospital policies, and nursing duties include support to individuals of all ages and their families. Clinical decisions are made independently during the scheduled shift; maintains complete accountability for all actions taken. Consults with the appropriate manager/supervisor and/or ancillary department in difficult situations requiring additional input or resources. Able to react in a calm manner and make sound nursing judgments in an emergent situation. Accountable for proper delegation and supervision of CNA/Tech. SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement. Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more. Key Essential Functions and Accountabilities of the Job Provide the total nursing activities and supervise subordinates for all patients/residents during working hours, assuring patient/resident safety. Develop and maintain a good working rapport with inter-departmental personnel as well as other departments within the facility to assure nursing services and activities are adequately maintained to meet the needs of the patients/residents. Assist in developing and maintaining nursing objectives and standards. Assist in developing, implementing, and coordinating department policies and procedures, resident/patient care plans, nursing procedure manuals, job descriptions, etc. Interpret department policies and procedures to personnel, resident/patients, visitors, family members, etc., as necessary. Ensure each patient’s/resident’s right to fair and equitable treatment, self-determination, individuality, privacy, property, and civil rights including the right to wage a complaint, are followed by the appropriate personnel. Assure established infection control procedures and isolation techniques are strictly followed Create and maintain an atmosphere or warmth, personal interest, and positive environment. Assist in training department personnel and make recommendations to the Chief Nursing Officer (CNO)/Director of Nursing (DON) concerning training. Perform administrative requirements such as completing necessary forms, reports, etc., and submitting to the CNO/DON. Assist in evaluating and assisting medical, social, psychological, spiritual, restorative, and rehabilitative care plans, as well as instructions in self-help Maintain confidentiality of all pertinent patient/resident care information to ensure the patients’/residents’ rights are protected. Evaluate emergencies and determine emergency measures to be used. Make independent decisions regarding nursing care. Complete required record-keeping forms on patient/resident admission, discharge, transfer, etc. Assure that all nurses’ notes are informative and descriptive of the nursing care provided and of the patient’s response to care. Notify physician of accidents and fill out/complete accident/incident report forms. Assure that stock levels of medications, medical supplies, equipment, etc., are maintained at adequate levels at all times. Report needs to the CNO/DON or Purchasing Agent. Attend and participate in staff/department meetings, workshops, seminars, etc., as approved. Give and receive nursing report upon reporting in and ending shift work hours. Receive verbal orders from physicians and chart on the physician’s order sheet or the electronic medical record. Transcribe physician’s orders to the electronic documentations system, lab slips, MAR, dietary requisitions, etc. Complete work requisitions for unsafe conditions or equipment repairs. Observe, record, and report to physician patient’s condition and reaction to drugs, treatments, and significant incidents. Other duties as deemed necessary and appropriate or as may be directed. Physical Working Conditions Must be able to move intermittently throughout the workday. Must be able to cope with the mental and emotional stress of the position. Must possess sight/hearing senses or use prosthetics that enable these senses to function adequately so that the position requirements can be fully met. Must function independently, have flexibility, personal integrity, and work effectively with patients/residents, personnel, and support agencies. Must be in good general health. Must demonstrate emotional stability. Must be able to relate to and work with ill, disabled, elderly, emotionally upset, and (at times) hostile people within the facility. May be required to life patients/residents, medical equipment, supplies, etc. Education, Certifications, and Licenses Required Graduate of an accredited school of nursing (Bachelor’s degree in nursing, Associate’s degree in nursing, or Diploma in nursing) Current full, unrestricted Registered Nursing license in Alaska or other U.S. state required. Direct Hire must have applied for an Alaska nursing license before start date. Agency staff must have an active Alaska license. BLS, ACLS, and PALS or must be obtained within 6 months of hire and maintained biannually thereafter. Trauma Nursing Core Course (TNCC) certification preferred (Required for ED nurses). High school diploma or equivalent required. Clinical Competency required within 3 months of hire and every three years High Risk Competency required within 3 months of hire and every year Experience Required None required. Acute care, emergency department, and/or long-term care experience preferred. Knowledge of Nursing/medical practices and procedures Laws, regulations, and guidelines pertaining to hospital and/or long-term care. Skills in Working harmoniously with and supervising professional and non-professional personnel. Seeking out new methods and principles; incorporating them into existing nursing practices. Ability to Read, write, and speak English fluently. Make independent decisions when circumstances warrant such action. Deal tactfully with personnel, patients/residents, family members, visitors, government agencies/personnel, and the public. Plan, organize, develop, implement, and interpret programs, goals, objective, policies, procedures, etc., of the Nursing Service Department. Maintain the care and use of supplies, equipment, etc. Maintain the appearance of nursing areas. Perform regular inspections of nursing unit for sanitation, order, safety, and proper performance of assigned duties. Utilize patience, tactfulness, cheerful disposition, and enthusiasm. Handle patients/residents based on whatever level at which they are currently functioning. Physical Demands: While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk; sit; use hands to finger, handle or feel and reach with hands and arms. The employee is occasionally required to climb or balance; stoop, kneel, crouch or crawl. The employee must lift and/or move 50 lbs. Required Certifications : Advanced Cardiovascular Life Support (ACLS) - American Heart Association, Basic Life Support (BLS) - American Heart Association, Clinical Competency Assessment - SEARHC, High Risk Competency - SEARHC, Pediatric Advanced Life Support (PALS) - American Heart Association, Registered Nurse License - State of Alaska - Alaska State Board of Nursing If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!