External Transfer Coordinator
3 weeks ago
**Company Description**
At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?
The **External Transfer Coordinator** reflects the mission, vision, and values of Northwestern Memorial, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.
This role is a registered professional nurse who facilitates the transfer of patients including spinal cord/trauma patients to NMH in collaboration with members of the health care team. Responsibilities include coordination of the optimal patient placement on appropriate nursing units, communication between sending and receiving nursing units, hospitals and physicians. This role interfaces with internal and external parties to facilitate patient bed assignment, supplies, and equipment. The External Transfer Coordinator manages the cost of care through insurance verification and approval, level of care assignment and problem solve other related issues as they are identified.
**Responsibilities**:
- Intake coordinator for all external transfers including spinal cord/trauma transfers.
- Ensures that NMH physician will accept patient and that communication with sending hospital is complete.
- Integrates and Coordinates the complex communication that occurs between NMH physicians and the sending physician/hospital to the nursing unit receiving the patient.
- Follow the appropriate established guidelines for a Spinal Cord Transfer vs. External Transfer accepted by an Attending physician.
- Assimilates information from multiple sources and determines appropriate bed placement to provide safe, quality care.
- Assures safety and security of patients and staff.
Clinical:
- Demonstrates clinical competence.
- Demonstrates cost effective approach to bed assignment in terms of equipment, supplies and all other resources.
- In all areas of clinical practice follows established polices and procedures.
- Assesses and intervenes in critical situations involving patient assignments, staff, visitors, and consults with manager, director, or hospital administrator for guidance as needed.
- Provide clinical explanations to bed assignment staff if RC must change a patient’s room assignment based on a clinical issue.
- When faced with two requests for one bed on a given unit, assures that the more clinically complex patient is placed on the “home” unit: the less clinically complex patient is overflowed to an appropriate unit.
- Able to identify questionable diagnosis, and asks additional clinical questions so that the patient is assigned to the most appropriate unit and room type (negative airflow, isolation requirements, ICU vs. general care unit assignment, telemetry).
- Performs pre-admission utilization management functions in accordance with established procedures.
- Masters the use of the utilization management medical necessity criteria to determine appropriate level of care upon admission.
- Monitors and assures clinical appropriateness of services and efficient use of the various levels of care and resources by working closely with members of the health care team, including the attending physician, house staff, and physician advisers on cases which do not meet established criteria.
- Communicates/collaborates with external case managers and payers by providing accurate clinical information as needed.
Actively Participates in Clinical Performance Improvement Activities related to Case Management Services:
- Assists in the collection and reporting of financial indicators including LOS, avoidable days, resource utilization, discharge barriers, cost per case, readmission rates, denial and appeals.
- Uses data to drive decisions and plan/implement performance improvement strategies related to case management for assigned patients/units, including financial, clinical, quality and patient satisfaction data.
- Collects data for discharge delays, over-utilization of resources, avoidable days and other data for specific performance and/or outcome indicators.
- Participates in the development, implementation, evaluation and revision of case management tools in collaboration with healthcare team.
- Participates in department/divisional or hospital committees/task forces.
Professional:
- Exemplifies a professional image in appearance, manner, and presentation.
- Upholds the Northwestern Memorial Hospital
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