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Coord, Clinical Care (SO) Northwell Health
Job Description
Evaluates and assesses of patients admitted to the Hospital.
Job Responsibility
* Performs concurrent review on all patients and share all problematic cases with the Supervisor and Physician Advisor.
* Determines and makes appropriate referrals concerning alternate level of care.
* Processes adverse determination decision to Physician Advisor and distributes notification, as appropriate.
* Identifies problematic care patterns or cases and make referrals to the Supervisor and the department involved.
* Performs retrospective reviews as required.
* Participates in the maintenance of Utilization Management, Discharge Planning and Case Management statistics as required.
* Keeps abreast of all changes in policies and procedures relating to Utilization Management, Discharge Planning and Case Management process.
* Attends Utilization Management Committee and other staff meetings, as required.
* Participates, as required, in ALC meetings.
* Participates in Interdisciplinary Patient Care Rounds.
* Identifies services or treatments that may not be medically necessary and make referrals to the Physician Advisor.
* Consults with physicians and other health care professionals on aspects of patient care.
* Makes referrals to other hospital departments for collaboration and assistance in discharge planning.
* Implements a discharge plan as necessary; document ongoing discharge planning activities in the patient's medical record according to protocol.
* Schedules family/patient conferences with the interdisciplinary team, as needed, to assist in coordinating a safe and timely discharge plan.
* Collaborates with appropriate professional personnel to assess patients for alternative level of care and notify appropriate hospital departments.
* Refers patients who require institutional placement to the Social Work Department for follow up and action.
* Acts as a liaison with patient's insurance carrier (case manager, utilization reviewer) to coordinate post hospital services and referrals.
* Makes arrangement for non-North Shore-Long Island Jewish Home Care services including home care, Hospice, equipment, supplies and laboratory services for post discharge needs.
* Arranges for patient's post hospital needs, i.e visiting nurse, physical therapy, medical/social model day care, personal care aides, Long Term Home Health Care Programs, home health aides, private hire, DME (equipment, supplies, and respiratory needs).
* Assists in identifying patient incidents through the NYPORTS program.
* Performs any and all related duties as required.
* Performs Clinical Care Coordination assessment within 72 hours of admission on all patients. Perform ongoing reviews every 48 hours or as necessary.
* Communicates with physicians to ascertain clarification of documentation to justify severity of illness, intensity of service and quality of patient care.
* Keeps abreast of all changes in Medicare/Medicaid/Commercial Insurances as it relates to the clinical documentation process, the utilization management process and the case management process.
* Shares all problematic cases with the Supervisor of CM-CCC.
* Identifies problematic documentation patterns or cases and make referrals to the appropriate departments, to the Supervisor of CM-CCC and/or the Physician Advisor.
Performs any and all related duties.
*ADA Essential Function.
Job Qualification
Graduate from an accredited School of Nursing. Bachelor's Degree in Nursing, preferred. Must be enrolled in an accredited program within 24 months of employment, if hired after September 1, 2010 and obtain a BSN degree within five (5) years of employment date.
Current license to practice as a Registered Professional Nurse in New York State.
Minimum of two (2) years medical/surgical experience in an acute-care hospital. Experience in utilization management/discharge planning, preferred.
*Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
Experience Step Plan: Min: $53.1944 Max: $76.7190
Bay Shore, NY, US, 11706Posted 5 hours ago Registered Nurse (RN) - Residency Medicine - Clinical. Northwell Health Exercises professional skills related to the plan of care; reassesses patients as needed and appropriately revises plan of care; correctly administers prescribed treatments; correctly uses equipment necessary for patient care; provides emotional support to patient and significant other; applies scientific principles in performing procedures; carries them out safely, timely and efficiently; makes accurate observations of patient's conditions during treatments/procedures; reports and records same as appropriate; Keeps accurate documentation of patient's treatment, activity and condition, as well as patient's responses to medical and nursing interventions; uses appropriate methods of documentation according to departmental policy; acts rapidly and effectively during any emergency situation, managing self, patients and other employees; provides a calm, quiet, restful atmosphere; communicates effectively with the patient's family or caretakers; participates in planning for discharge and coordinates referrals, as appropriate; provides discharge instructions to patient and significant other; evaluates care provided for patient outcome. Chappaqua, NY, US, 10514Posted 5 hours ago Registered Nurse - Ambulatory- Internal Medicine. Northwell Health 5.Implements the plan of care; maintains constant vigilance over patients care to ensure that safety precautions/needs are followed (side rails up, call lights and bedside stand within reach, etc.; exercises professional skills related to the plan of care; reassesses patients as needed and appropriately revises plan of care; correctly administers prescribed treatments; correctly uses equipment necessary for patient care; provides emotional support to patient and significant other; applies scientific principles in performing procedures; carries them out safely, timely and efficiently; makes accurate observations of patient's conditions during treatments/procedures; reports and records same as appropriate; keeps accurate documentation of patient's treatment, activity and condition, as well as patient's responses to medical and nursing interventions; uses appropriate methods of documentation according to departmental policy; acts rapidly and effectively during any emergency situation, managing self, patients and other employees; provides a calm, quiet, restful atmosphere; communicates effectively with the patient's family or caretakers; participates in planning for discharge and coordinates referrals, as appropriate; provides discharge instructions to patient and significant other; evaluates care provided for patient outcome. Bethpage, NY, US, 11714Posted 5 hours ago Registered Nurse - PICU. Northwell Health Exercises professional skills related to the plan of care; reassesses patients as needed and appropriately revises plan of care; correctly administers prescribed treatments; correctly uses equipment necessary for patient care; provides emotional support to patient and significant other; applies scientific principles in performing procedures; carries them out safely, timely and efficiently; makes accurate observations of patient's conditions during treatments/procedures; reports and records same as appropriate; Keeps accurate documentation of patient's treatment, activity and condition, as well as patient's responses to medical and nursing interventions; uses appropriate methods of documentation according to departmental policy; acts rapidly and effectively during any emergency situation, managing self, patients and other employees; provides a calm, quiet, restful atmosphere; communicates effectively with the patient's family or caretakers; participates in planning for discharge and coordinates referrals, as appropriate; provides discharge instructions to patient and significant other; evaluates care provided for patient outcome. New Hyde Park, NY, US, 11044Posted 5 hours ago Home Care Registered Nurse - Fee for Service - Regioncare. Northwell Health 4.Exercises professional skills related to the plan of care; reassesses patients as needed and appropriately revises plan of care; correctly administers prescribed treatments; correctly uses equipment necessary for patient care; provides emotional support to patient and significant other; applies scientific principles in performing procedures; carries them out safely, timely and efficiently; makes accurate observations of patient's conditions during treatments/procedures; reports and records same as appropriate; Keeps accurate documentation of patient's treatment, activity and condition, as well as patient's responses to medical and nursing interventions; uses appropriate methods of documentation according to departmental policy; acts rapidly and effectively during any emergency situation, managing self, patients and other employees; provides a calm, quiet, restful atmosphere; communicates effectively with the patient's family or caretakers; participates in planning for discharge and coordinates referrals, as appropriate; provides discharge instructions to patient and significant other; evaluates care provided for patient outcome. Jamaica, NY, US, 11406Posted 5 hours ago Registered Nurse-Recovery Room. Northwell Health Exercises professional skills related to the plan of care; reassesses patients as needed and appropriately revises plan of care; correctly administers prescribed treatments; correctly uses equipment necessary for patient care; provides emotional support to patient and significant other; applies scientific principles in performing procedures; carries them out safely, timely and efficiently; makes accurate observations of patient's conditions during treatments/procedures; reports and records same as appropriate; Keeps accurate documentation of patient's treatment, activity and condition, as well as patient's responses to medical and nursing interventions; uses appropriate methods of documentation according to departmental policy; acts rapidly and effectively during any emergency situation, managing self, patients and other employees; provides a calm, quiet, restful atmosphere; communicates effectively with the patient's family or caretakers; participates in planning for discharge and coordinates referrals, as appropriate; provides discharge instructions to patient and significant other; evaluates care provided for patient outcome. Glen Cove, NY, US, 11542Posted 5 hours ago Patient Care Technician - Med/Surg - F/T with Benefits Night. Hackensack Meridian Health Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. Edison, NJ, US, 08837Posted 5 hours ago Supervisor, Operations. Northwell Health 10.Ensures participation in quality initiatives to improve healthcare and ensure patient safety; aligns programs with hospital quality management initiatives if applicable; coordinates participation in mandatory and non-mandatory performance improvement initiatives at the practice level; implements and monitors changes required related to various regulatory agency standards and/or public health law; manages compliance with Joint Commission, Department of Health, Public Health Laws, Institutional and Departmental rules and regulations. New York, NY, US, 10111Posted 5 hours ago Patient Care Technician - Stroke Unit - Per Diem Day. Hackensack Meridian Health Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. Edison, NJ, US, 08837Posted 5 hours ago Sales Representative. Sysco This is an outside sales position responsible for promoting the company's products and services and for building relationships with new and existing accounts. The main focus is to help Sysco customers succeed while achieving sales and profit goals established by the company. This position may require working some non-traditional hours (evening, weekends, and holidays) to successfully meet customers' needs. Newark, NJ, US, 07175Posted 5 hours ago Description
Job Description
Evaluates and assesses of patients admitted to the Hospital.
Job Responsibility
* Performs concurrent review on all patients and share all problematic cases with the Supervisor and Physician Advisor.
* Determines and makes appropriate referrals concerning alternate level of care.
* Processes adverse determination decision to Physician Advisor and distributes notification, as appropriate.
* Identifies problematic care patterns or cases and make referrals to the Supervisor and the department involved.
* Performs retrospective reviews as required.
* Participates in the maintenance of Utilization Management, Discharge Planning and Case Management statistics as required.
* Keeps abreast of all changes in policies and procedures relating to Utilization Management, Discharge Planning and Case Management process.
* Attends Utilization Management Committee and other staff meetings, as required.
* Participates, as required, in ALC meetings.
* Participates in Interdisciplinary Patient Care Rounds.
* Identifies services or treatments that may not be medically necessary and make referrals to the Physician Advisor.
* Consults with physicians and other health care professionals on aspects of patient care.
* Makes referrals to other hospital departments for collaboration and assistance in discharge planning.
* Implements a discharge plan as necessary; document ongoing discharge planning activities in the patient's medical record according to protocol.
* Schedules family/patient conferences with the interdisciplinary team, as needed, to assist in coordinating a safe and timely discharge plan.
* Collaborates with appropriate professional personnel to assess patients for alternative level of care and notify appropriate hospital departments.
* Refers patients who require institutional placement to the Social Work Department for follow up and action.
* Acts as a liaison with patient's insurance carrier (case manager, utilization reviewer) to coordinate post hospital services and referrals.
* Makes arrangement for non-North Shore-Long Island Jewish Home Care services including home care, Hospice, equipment, supplies and laboratory services for post discharge needs.
* Arranges for patient's post hospital needs, i.e visiting nurse, physical therapy, medical/social model day care, personal care aides, Long Term Home Health Care Programs, home health aides, private hire, DME (equipment, supplies, and respiratory needs).
* Assists in identifying patient incidents through the NYPORTS program.
* Performs any and all related duties as required.
* Performs Clinical Care Coordination assessment within 72 hours of admission on all patients. Perform ongoing reviews every 48 hours or as necessary.
* Communicates with physicians to ascertain clarification of documentation to justify severity of illness, intensity of service and quality of patient care.
* Keeps abreast of all changes in Medicare/Medicaid/Commercial Insurances as it relates to the clinical documentation process, the utilization management process and the case management process.
* Shares all problematic cases with the Supervisor of CM-CCC.
* Identifies problematic documentation patterns or cases and make referrals to the appropriate departments, to the Supervisor of CM-CCC and/or the Physician Advisor.
Performs any and all related duties.
*ADA Essential Function.
Job Qualification
Graduate from an accredited School of Nursing. Bachelor's Degree in Nursing, preferred. Must be enrolled in an accredited program within 24 months of employment, if hired after September 1, 2010 and obtain a BSN degree within five (5) years of employment date.
Current license to practice as a Registered Professional Nurse in New York State.
Minimum of two (2) years medical/surgical experience in an acute-care hospital. Experience in utilization management/discharge planning, preferred.
*Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
Experience Step Plan: Min: $53.1944 Max: $76.7190
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