GBMC or St. Agnes as primary assignment with the expectation that one may have travel between GBMC, St. Agnes Hospital or Calvert Street office if operations requires. Rotating Schedule
The Patient Care Coordinator is responsible for utilization review, discharge planning & transitions in care, in collaboration w/ MAPMG rounder in acute or alternative settings of care.
Essential Functions:
- Utilization Review. According to department policy, procedure & protocols, consistently apply & verbally communicate approved utilization review criteria & guidelines for services delivered in acute or alternative care settings.
- Eligibility & Benefit Verification. Confirm eligibility status & ensure the appropriate administration of benefits in accordance w/ department policies & procedures.
- Assessing Right Venue of Care w/ Hospitalist. Collaboration w/ Hospitalist to assess the appropriate level of care for patients (i.e., Medical Unit, Surgical Unit, Tele Unit, TCU, ICU) & post- (Home, Continuum or Community-based Services) hospitalization.
- Coordination of Care. Driving patient care plan through assuring daily plan is executed, & management of transitions & post-hospital care.
- Effective Discharge Planning. Prompt, clinically appropriate discharge planning beginning at time of admission.
- Variance Management. Timely steps in identification of delays in throughput, escalation to correct delays, & recording delays to identify patterns & trends that will require corrective actions.
- Quality Screening. Demonstrate competency to assess all aspects of care across the continuum for variations from quality & utilization standards.
- Performs other related duties as directed.
Qualifications:
Basic Qualifications:
- 2 years of experience in acute hospital utilization review or equivalent required.
- RN License in jurisdiction where assigned required
- CPR certification required.
- New Hire:
o Successful completion of PCC Orientation & Assessment of Critical Skills.
o Passing score on inter-rater reliability.
- Annually:
o Successful completion of PCC Assessment of Critical Skills.
o Passing score on inter-rater reliability.
- Ability to effectively communicate.
- Ability to conform to established policies & procedures.
- Ability to analytically problem solve & make decisions.
- Ability to tolerate & cope w/ ambiguity.
- Ability to work as a team member.
- Proficiency in the use of applicable computer software.
- Demonstrated ability to effectively & clearly present information through the written word, to influence or persuade others through oral presentation in positive or negative circumstances, & to listen well.
- Demonstrated ability to write clearly, legibly, & effectively, to present ideas & document activities, to read & interpret written information.
Preferred Qualifications:
- Recent acute care, case management, or home health experience preferred.
- B.S.N. preferred.
Preferred Skiils:
Acute Care Hospital Case Management and Utilization Experience 2 + years. Excellent interpersonal and problem solving skills.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.