Clinical Access Nurse PRN Utilization Management
Clinical Access Nurse PRN Utilization Management
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
The Clinical Access Nurse assists with the preliminary step of the utilization management process and serves as the access point for admissions. Is responsible for obtaining orders on all patients for appropriate status and level of care using InterQual criteria. Obtains precertification and insurance verification on transfers from other facilities and works in conjunction with patient care services for proper bed utilization and assignment.
Responsibilities
- Quality and Compliance
- Determines medical necessity and level of care guidelines using InterQual criteria for admissions. Has an understanding of specific criteria required for admission concurrent stay and an understanding of level of care and criteria subsets within each level of care. Ensures the compliance of EMTALA/COBRA regulations as it applies to transfers from outside facilities.
- Promotes the quality and efficiency of his/her own performance through participation in staff educational programs approved continuing education courses and specialized skill training programs.
- Collaboration and Partnership
- Works closely with the acute Clinical Resource Coordinators utilizing information provided by the admitting physician to notify of any potentially difficult cases to ensure coordination of discharge planning upon admission.
- Queries the admitting physician for more information to determine medical necessity of the admission or appropriate level of care. The Access nurse will have the knowledge to direct the physician to an alternative level of care including skilled care nursing home or outpatient services.
- Coordinates appropriate bed placement in conjunction with Patient Care Services and the Bed Coordinator.
- Other Duties as Assigned
- Performs other duties as assigned or requested.
Qualifications
- 3 years in general or specialty nursing practice
- Diploma Associates Degree or Bachelors Degree from accredited RN program
- Current and unrestricted Louisiana RN license
Employment Type
Gig
