Clinical Care Coordinator RN
4 weeks ago
Job Summary:
The Registered Nurse Clinical Care Coordinator is a key member of the CHRISTUS Health team, responsible for ensuring the effective and efficient admission/placement of patients into the health system. This role requires strong clinical knowledge, problem-solving skills, and excellent customer service to determine the best course of action for patients, physicians, and the hospital.
Key Responsibilities:
- Reviews clinical information for patients upon entry into the health system to determine appropriate placement and patient class to maximize hospital reimbursement and positively manage length of stay.
- Coordinates with onsite partner providers to review requests for facility services and ensure appropriate use of outpatient hospital resources.
- Reviews all ED patients identified by the treating physician as requiring admission to the hospital to ensure appropriate patient class and resource utilization.
- Provides education to hospital and ED providers on levels of care, resource utilization, payor practices, and documentation.
- Performs initial clinical medical necessity review utilizing evidence-based criteria and enters into the medical record for the receiving CM team.
- Provides after-hour and weekend support to the entire hospital from a Care Management standpoint to include facilitating discharges after business hours and responding to physician support needs and inquiries.
- Reviews all post-surgical patients who are placed in a bed to confirm appropriate patient class/admission status and works with physicians to correct patient class when errors are identified.
- Responsible for 24/7 ongoing management of patients in Observation status to include repeated review of clinical and opportunities for conversion to inpatient status.
- Works closely to coordinate and collaborate with the ED Case Manager regarding patient class, discharge planning from ED, and avoidance of readmissions.
Requirements:
- Graduate of an accredited school of nursing is required.
- Minimum of two (2) years' experience in Case Management and/or Utilization Management is required.
- RN License in the state of employment required.
- BLS is required.
Work Schedule: TBD
Work Type: Full Time
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