Patient Access Nurse Supervisor

Job Family:

Travel Required:

Clearance Required:

What You Will Do:

The Patient Access Nurse Supervisor (PANS) will report to the Patient Access Director. The PANS will work directly along with the team as well as oversees the Patient Access nurses in day to day operations to ensure they are facilitating patient medical and financial clearance using nursing knowledge clinical judgment and communication skills to assist in resolving difficulties surrounding patient access and authorization of services.

Duties and Responsibilities

• Consistently and accurately utilizes medical acceptance criteria to screen Emergency Room patients in a way to ensure optimal efficiency in the Patient Access operations.
• Performs clinical review of all inpatients to determine medical acceptance following the Miliman guidelines and communicates with patients and physicians who fail to meet medical criteria for acceptance.
• Uses excellent oral communication and listening skills to communicate with patient physician and clinical staff regarding obstacles to access or financial clearance.
• Review and updated department policies procedures training material and/or job aides as needed.
• Establish and maintain productivity and quality reporting
• Provide real-time feedback to staff to facilitate a teaming and quality culture
• Proactively lead by example demonstrating quality and collaboration
• Consistently maintain licensed nursing credentials
• Facilitate a culture of teaming collaboration and high ethical standards within the department and throughout the organization
• Independently develop reports and presentations to support departmental needs
• Responds to voicemails within one business day and answers phone calls in a timely manner.
• Completely and accurately documents communications with payors patients and the treatment team.
• Monitor Medicare One Day Stay admissions and report data trends to UM Committee
• Perform audit reviews on teams MCGs to provide feedback and education to team members
• Assists in monitoring and trending medical necessity denials and assist in creating action plans to reduce denial.

What You Will Need:

• Bachelors Degree- preferably in Nursing
• Active RN in State of California
• 7 years of prior relevant experience in Bed Board Hospital or Nursing experience

What Would Be Nice To Have:

• Masters Degree
• Utilization Review Experience
• 1 year Supervisory/ Management Experience

What We Offer:

Guidehouse offers a comprehensive total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical Rx Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Tuition Reimbursement Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Opportunity EmployerProtected Veterans Individuals with Disabilities or any other basis protected by law ordinance or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities or to apply for a position and you require an accommodation please contact Guidehouse Recruiting at 1- or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @ or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse please report the matter to Guidehouses Ethics Hotline. If you want to check the validity of correspondence you have received please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicants dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.