Provides comprehensive care coordination for patients as assigned, including initiation and coordination of incoming and outgoing transfers for higher/lower level of care and/or specialized treatment modalities from outreach or network entities. This position secures required specialists and/or following physicians, assessment and triage for appropriate level of care, financial assessment and referral. This position also carries out market strategies to obtain referral of clients from third part payers and physicians in liaison role.
Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes. Assesses patient admissions and continued stay, utilizing standard criteria.
Coordinates patient placement among multiple outreach and network facilities for admissions and transfers. Coordinates safe patient transfers according to established operational processes and guidelines in place for all service lines at each facility. Alerts staff at appropriate entity/agency of incoming/outgoing patients, scheduling bed/services, performs clinical and financial screening of referred patients and coordinates transportation. Serves as a liaison with other departments, leaders and presiding physicians regarding process improvement opportunities for patient flow, patient transfers and efficacy of communication process.
Manages individual patients across the healthcare continuum to achieve the optimal clinical, financial, operational and satisfaction outcomes. Serves as a liaison for the continuum of care including preadmission, hospitalization and community follow-up, depending on work assignment.
Maintains process for assessing current referral patterns for selected target areas by identifying physician referral patterns, health related community events, established physician practices and major gatekeepers in outreach and network communities. Establishes and promotes collaborative relationships with physicians, payers and other members of the healthcare team, including non-Banner entities (vendor management). Seeks opportunities to increase the growth of business within the assigned communities, identifying and cultivating potential referral sources relevant to the population served.
Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. Provides outcome data with targeted audiences including physicians, medical case managers, rehabilitation professionals, insurance adjustors and industrial representatives.
Serves as a resource to other staff members and promotes a collegiality between staff physicians and leaders. Participates in interdisciplinary healthcare teams to facilitate the integration of managed care concepts within the daily practice standards. Acts as a consultant within the organization and in the community.
Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks and participating in professional societies.
May supervise staff depending on work assignment.
May require a current valid RN license in state of practice, temporary RN license in state of practice, or compact RN licensure for current state of practice. May require a current Physical, Occupational or Speech Therapy license within the State of practice.
Requires knowledge typically achieved with three years of experience in the care of the population served, as well as experience in clinical care operations, case management and/or patient throughput. Must have a working knowledge of hospital operations, medical/nursing staff procedures, hospital and community resources. Must demonstrate critical thinking, conflict resolution, time management, and problem-solving skills. Requires excellent communication skills and an ability to interact well across departments, facilities and organizations. Excellent organizational and human relations are required to maintain good rapport and effective working relationships with internal and external customers.
Bachelors degree in nursing or healthcare related field preferred.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.