Care Transitions RN

3 weeks ago

Lincoln, United States Bryan Health Full time

Summary


GENERAL SUMMARY:

The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and utilization coordination of the patient's hospital experience. Proactively consults with the interdisciplinary team which includes but is not limited to hospital patient care staff, physicians, patient support and family and community resources to assure a smooth transition for the patient through appropriate levels of care in order to facilitate quality outcomes.

PRINCIPAL JOB FUNCTIONS:

*Commits to the mission, vision, beliefs and consistently demonstrates our core values.

*Utilizes clinical skills to create and update personalized transitional care plans for patients.

*Performs transition planning activities at onset and throughout the patient's hospitalization.

*Collaborates with the patient's provider and other healthcare team members in managing the patient's length of stay and determining the appropriate level of care for transition planning.

*Assists in identifying need for supportive counseling or post discharge extended psychosocial therapy and consults with attending Physician for referral to appropriate provider.

*Maintains awareness of financial reimbursement methodology, utilization management, payer/reimbursement practices and regulations and participates in resource stewardship.

*Promotes quality improvement initiatives and health care outcomes based on currently accepted clinical practice guidelines and total quality improvement initiatives.

EDUCATION AND EXPERIENCE:

Current Registered Nurse licensure from the State of Nebraska or approved compact state of residence as defined by the Nebraska Nurse Practice Act. Minimum of two (2) years recent clinical experience required. Prior care coordination and/or utilization management experience preferred. Basic Life Support (CPR) certification required.

ACUTE REHABILITATION

ADDITIONAL JOB FUNCTIONS:

In addition to the principal job functions contained on the primary job descriptions, the following duties are also required in the department noted above.

  1. Responsible for the early identification of potential patients through interdisciplinary team members and medical record review.
  2. Provides education to patients, family and support members, internal and external referral sources on Rehab program benefits and services; coordinates tours of facility when requested.
  3. Performs utilization review activities, including preadmission screening, insurance verification for benefits, medical necessity reviews, denial and appeals and coordinates admissions with admitting physicians and staff.
  4. Serves as an internal and external resource regarding Medicare/Medicaid rules, regulations and policies; 3rd party and managed care contracts, and authorization for post-acute services.

EMERGENCY DEPARTMENT

ADDITIONAL JOB FUNCTIONS:

In addition to the principal job functions contained on the primary job descriptions, the following duties are also required in the department noted above.

  1. Collaborates with the ED physicians, admitting physicians, and Bed Management to assist in determining appropriate bed status/classification for all patients.
  2. Completes medical necessity reviews utilizing approved evidence based guidelines/criteria for patients being admitted to the hospital from all portals of entry, including but not limited to: ED admissions, direct admissions, hospital to hospital transfers, post procedure admissions, and surgical admissions.
  3. Completes high risk screening for discharge planning and coordinates with social work and healthcare partners for potential post-acute needs.
  4. Serves as an internal and external resource regarding appropriate level of care; admission status/classification; Medicare/Medicaid rules, regulations, and policies; 3rd party and managed care contracts; discharge planning; and length of stay.

UTILIZATION MANAGEMENT

ADDITIONAL JOB FUNCTIONS:

In addition to the principal job functions contained on the primary job descriptions, the following duties are also required in the department noted above.

  1. Performs utilization review activities, including concurrent and retrospective reviews as required.
  2. Determines the medical necessity of request by performing first level reviews, using approved evidence based guidelines/criteria.
  3. Refers cases to reviewing physician when the treatment request does not meet criteria per appropriate algorithm.
  4. Participates in concurrent and retrospective denials and appeals process by researching issues surrounding the denial, participating in all levels of the appeal and process follow-up.
  5. Serves as an internal and external resource regarding appropriate level of care; admission status/classification; Medicare/Medicaid rules, regulations, and policies; 3rd party and managed care contracts; discharge planning; and length of stay.

  • Care Transitions RN

    3 weeks ago

    Lincoln, United States Bryan Health Full time

    GENERAL SUMMARY:The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and utilization coordination of the patient's hospital experience. Proactively consults with the interdisciplinary team which includes but is not limited to hospital patient care staff, physicians, patient support and family and community resources to assure...

  • Care Transitions RN

    1 month ago

    Lincoln, United States Bryan Health Full time

    GENERAL SUMMARY: The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and utilization coordination of the patient's hospital experience. Proactively consults with the interdisciplinary team which includes but is not limited to hospital patient care staff, physicians, patient support and family and community resources to...

  • Care Transitions RN

    6 days ago

    lincoln, United States Bryan Health Full time

    Summary GENERAL SUMMARY: The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and utilization coordination of the patient's hospital experience. Proactively consults with the interdisciplinary team which includes but is not limited to hospital patient care staff, physicians, patient support and family and community...

  • Care Transitions RN

    2 weeks ago

    Lincoln, NE, United States Bryan Health Full time

    Summary GENERAL SUMMARY: The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and utilization coordination of the patient's hospital experience. Proactively consults with the interdisciplinary team which includes but is not limited to hospital patient care staff, physicians, patient support and family and community...

  • Care Transitions RN

    3 weeks ago

    Lincoln, NE, United States Bryan Health Full time

    Summary GENERAL SUMMARY: The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and utilization coordination of the patient's hospital experience. Proactively consults with the interdisciplinary team which includes but is not limited to hospital patient care staff, physicians, patient support and family and community...

  • Bryan Health | Care Transitions RN | lincoln, ne

    2 days ago

    lincoln, United States Bryan Health Full time

    Summary GENERAL SUMMARY: The Care Transitions RN conducts day-to-day activities for the clinical, psychosocial and utilization coordination of the patient's hospital experience. Proactively consults with the interdisciplinary team which includes but is not limited to hospital patient care staff, physicians, patient support and family and community...

  • Staff RN

    6 days ago

    lincoln, United States Bryan Health Full time

    Summary The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in interdisciplinary care planning, providing and /or delegating care and evaluating patients' responses and progress toward clinical outcomes. The Staff RN contributes to an efficient and effective work environment through activities...

  • Staff RN

    3 weeks ago

    Lincoln, United States Bryan Health Full time

    Summary The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in interdisciplinary care planning, providing and /or delegating care and evaluating patients' responses and progress toward clinical outcomes. The Staff RN contributes to an efficient and effective work environment through activities...

  • Staff RN-Critical Care Neuro/PCU

    3 weeks ago

    Lincoln, United States BryanLGH Medical Center Full time

    The Neurosciences RN manages the care of patients with conditions common to the neurosciences unit which may include: pre-op/post-op neurosurgical patients; patients with neurological impairments/multisystem failure; and trauma patients. The Staff Registered Nurse (RN) is responsible for meeting patient#s priority needs by assessing, participating in...

  • Staff RN

    3 weeks ago

    Lincoln, United States Bryan Health Full time

    SUMMARY The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in interdisciplinary care planning, providing and /or delegating care and evaluating patients' responses and progress toward clinical outcomes. The Staff RN contributes to an efficient and effective work environment through activities...

  • Staff RN-Med/Surg-Critical Care

    3 weeks ago

    Lincoln, United States BryanLGH Medical Center Full time

    The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in interdisciplinary care planning, providing and /or delegating care and evaluating patients' responses and progress toward clinical outcomes. The Staff RN contributes to an efficient and effective work environment through activities including...

  • Staff RN-Med/Surg-Critical Care

    2 weeks ago

    Lincoln, United States Bryan Health Full time

    The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in interdisciplinary care planning, providing and /or delegating care and evaluating patients' responses and progress toward clinical outcomes. The Staff RN contributes to an efficient and effective work environment through activities including...

  • Staff RN-Med/Surg-Critical Care

    4 weeks ago

    Lincoln, United States Bryan Health Full time

    The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in interdisciplinary care planning, providing and /or delegating care and evaluating patients' responses and progress toward clinical outcomes. The Staff RN contributes to an efficient and effective work environment through activities including...

  • Staff RN-Critical Care Neuro/PCU

    3 weeks ago

    Lincoln, United States Bryan Health Full time

    The Neurosciences RN manages the care of patients with conditions common to the neurosciences unit which may include: pre-op/post-op neurosurgical patients; patients with neurological impairments/multisystem failure; and trauma patients.The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in...

  • Staff RN-Critical Care Neuro/PCU

    3 weeks ago

    Lincoln, United States Bryan Health Full time

    The Neurosciences RN manages the care of patients with conditions common to the neurosciences unit which may include: pre-op/post-op neurosurgical patients; patients with neurological impairments/multisystem failure; and trauma patients. The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in...

  • Staff RN-Med/Surg-Critical Care

    1 week ago

    lincoln, United States Bryan Health Full time

    Summary The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in interdisciplinary care planning, providing and /or delegating care and evaluating patients' responses and progress toward clinical outcomes. The Staff RN contributes to an efficient and effective work environment through activities...

  • Staff RN-Med/Surg-Critical Care

    6 days ago

    lincoln, United States Bryan Health Full time

    Summary The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in interdisciplinary care planning, providing and /or delegating care and evaluating patients' responses and progress toward clinical outcomes. The Staff RN contributes to an efficient and effective work environment through activities...

  • Oncology Care Coordinator

    4 weeks ago

    Lincoln, Nebraska, United States Catholic Health Initiatives Full time

    Cancer Care NavigatorCatholic Health Initiatives is seeking a skilled Cancer Care Navigator to join our team. As a key member of our cancer care team, you will play a critical role in improving the coordination of cancer care for African-American and Hispanic patients in Lancaster County/Lincoln.ResponsibilitiesAssess the physical, psychosocial, and social...

  • Nurse Care Specialist

    3 weeks ago

    Lincoln, United States Genesis Healthcare Services Full time

    Job SummaryAs a Registered Nurse at Genesis HealthCare Services, you will have the opportunity to make a meaningful difference in the lives of our patients and residents. With a focus on delivering high-quality care and compassion, we are seeking a skilled and motivated RN to join our team.Key ResponsibilitiesPerform comprehensive nursing assessments and...

  • Staff RN-Med/Surg-Critical Care

    5 days ago

    LINCOLN, United States Bryan Health Full time

    Summary The Staff Registered Nurse (RN) is responsible for meeting patient's priority needs by assessing, participating in interdisciplinary care planning, providing and /or delegating care and evaluating patients' responses and progress toward clinical outcomes. The Staff RN contributes to an efficient and effective work environment through...