RN Care Coordinator

Company: Beaumont Health
Location: Grosse Pointe
Posted on: August 7, 2022

Job Description:

Shift: 3:30pm-12am midnightBeaumont is now offering a $10,000 sign-on bonus to regular full-time Registered Nurse new hires! - Apply today to speak with a Recruiter to learn more.* -Works in EC, have excellent communication skills, ability to work independently, has computer skills.GENERAL SUMMARY:Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of admission or continued stay based on medical necessity. The overall goal of the position is to enhance the quality of patient care and engagement, to promote continuity of care and cost effectiveness through the integration and functions of utilization management, and/or care coordination, discharge planning, and appropriate care transitions. Has accountability for the care coordination and discharge planning of all hospitalized patients.BENEFITSBeaumont offers a comprehensive benefits package to meet your financial, health and life-work balance goals.

• NEW On-demand pay program - powered by Payactiv
• Generous paid time off, holidays and flexible scheduling
• Our employees receive special discounts on a wide range of products and services
• Exceptional health, dental, vision and prescription drug insurance plans
• Relocation assistance
• Generous retirement savings, disability insurance, identify theft protection and even home and auto insurance
• Free onsite parking at all campusesESSENTIAL DUTIES:1. Identifies patients that need care management services (i.e. utilization review; care coordination; and/or discharge/transition planning).2. Responsible for managing a case load of patients that includes facilitating utilization management, and/or care coordination during the patient's stay, planning and expediting plans for safe and effective discharge and transition to the appropriate level of care and setting needed after hospitalization. Coordinating care by considering all patient's needs.3. Uses critical thinking and effective judgment to determine alternative courses of care. Judiciously uses tools designed to expedite care while being cost effective. Actively participates in readmission initiatives and strategies to maximize patient flow and appropriate resource utilization. Works collaboratively on processes to provide effective transition for patients utilizing hospital outpatient, observation or inpatient services.4. May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and appropriate reimbursement. Determines and assures appropriate status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff.5. Routinely communicates with payers, patients/family caregivers, physicians, the interdisciplinary team, post-acute and community-based care providers to facilitate coordination of care and to enhance a seamless transition from hospital setting to the appropriate alternative level of care.6. Seeks out information and resources to apply creative problem solving for complex discharge/transition planning, quality of care, and utilization management issues. Provides notification and communication to patients/families regarding coverage for hospital and post-acute services, in accordance with CMS regulations.7. Documents utilization reviews, utilization management actions, care management assessment(s), care plan, discharge plan, and interventions, according to policies, procedures, and regulatory, contractual, and legal requirements. Acts proactively to see that hospital resources are utilized appropriately.8. Works collaboratively with other departments to define areas of hospital inefficiency and participates in improvement projects.This document represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described.STANDARD REQUIREMENTS:1. Supports the Mission, Value and Vision of Beaumont Health (BH). Demonstrates personal commitment through active involvement in the performance improvement process.2. Exhibits excellent customer service skills and behaviors toward internal and external customers and co-workers. Promotes positive public relations with patients/residents, family members, guests, and others.3. Supports and adheres to all Beaumont Health's customer service, service excellence, and performance standards. Supports and participates with all required compliance standards that may be department specific and/or identified by the organizations including in-service training, acceptable attendance, uniform and dress code.4. Adheres to HIPAA requirements and maintains confidentiality of all data, including patient/resident, employee and operations information.5. Supports and participates in a collaborative team-oriented environment - cooperates and works together with all co-workers, plans and completes job duties, uses appropriate communications in sensitive and emotional situations and follows up as appropriate regarding reported complaints, problems and concerns.6. Supports, cooperates with and demonstrates safe work practices and attitudes, follows safety rules - including universal precautions - reports and prevents/corrects unsafe conditions and behaviors, and participates in organizational and departmental safety programs.7. Completes all required compliance standards that may be department specific and/or identified by the organization.8. Maintains current licensure, registration and/or certification, as applicable, at all times.STANDARD QUALIFICATIONS:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.A. Education / Training:
  --- Graduate of an accredited school of nursing. Bachelors of Science in Nursing degree required. Will consider non-BSN RN if actively pursuing a Bachelors degree in nursing with completion within 2 years of hire.B. Work Experience:
  --- Minimum two years' experience in the acute care setting. Preference three to five years' experience in care management, utilization review, home care and/or discharge planning.C. Certification, Licensure, Registration:
  --- Requires a current, unrestricted license to practice as a registered nurse in the State of Michigan. Certification in care management preferred. Current American Heart Association BLS for Healthcare Providers certification.D. Other Qualifications:
  --- Working knowledge of 3rd party requirements, excellent interpersonal and communication skills. Ability to act in an autonomous, self-directed manner in a fast-paced, ever-changing environment.WORKING CONDITIONS:A. Physical Effort:
  --- Position requires incumbent to occasionally perform physical activities necessitating ability to push/pull objects up to 20 pounds. Mobility skills such as walking and standing along with performing manual dexterity and coordination functions required.B. Work Environment:
  --- Incumbent may be occasionally exposed to blood, body fluids, and hazardous substances.
  --- Potential risk of an exposure to hazardous medications or waste materials of hazardous medications.Beaumont Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

Keywords: Beaumont Health, Detroit , RN Care Coordinator, Healthcare , Grosse Pointe, Michigan