RN Coordinator (Admission Screening) - Case Management - Full Time 8 Hour Days (Non-Exempt) (Non-Union)

The RN Admission Screening Coordinator provides oversight of pre-admission evidence-based criteria evaluations of non-transfer bed requests through identification of bed requests for non-transfer patients review of established evidenced-based criteria and adherence to established escalation processes to better ensure appropriate and timely reimbursement of these services rendered.

Essential Duties:

• Collaboration and communication with key stakeholders including: providers/managers/staff at clinics and hospitals ETC Capacity Management House Supervisors hospital financial counselors Utilization Management staff and Case Managers Physician Advisors and payers.
• Robust collaboration with hospital financial counselors Capacity Management and House Supervisor regarding bed requests for non-transfer patients.
• Evaluation of established evidence-based criteria for direct hospital admissions including but not limited to: proposed admission status; status of authorization obtained by clinic staff and / or hospital financial counselors; appropriate level of care at admission.
• Implementation of escalation processes including communication with provider and consultation with Physician Advisor when criteria are not met and/or proposed admission status is incorrect and the physician does not agree with RN Surgery Screening Coordinator determination.
• Facilitation of scheduling of Peer-to-Peer meetings when payer denial received.
• Documentation of evaluations including escalations and outcomes in the Electronic Medical Record (EMR) in a timely manner and viewable by key stakeholders such as Case Managers Physician Advisors Patient Access hospital financial counselors and Claims.
• Post-admission validation of status ordered to confirm it is in accordance with established CMS and hospital guidelines including Medicares Two Midnight Rule.
• Collection of admission screening evaluation data for reporting tracking and trending of identified quality improvement opportunities in department processes provider practices and payer determinations.
• Participation in department Inter-Rater Reliability process.
• Maintains competencies for hospital age specific and job specific standards of care; follows hospital procedures for accurate and timely processing of charges.
• Represents the department in a positive and professional manner.
• Supports orientation of new staff.
• Supports hospital and departmental protocols workflows policies procedures standards and competencies for clinical role.
• Supports the mission vision and values of the organization.
• Performs other duties as requested/assigned.

Required Qualifications:

• Req Bachelors Degree Nursing Degree from an accredited school of nursing

• Req 3 years Experience as a Registered Nurse
• Req 2 years Utilization Review and Case Management experience in an acute hospital setting
• Req Experience with InterQual evidence-based criteria.

• Req Demonstrates ability to utilize effective and appropriate oral and written communication skills.
• Req Demonstrates ability to effectively work with physicians staff patients and payers.
• Req Commitment to excellence inpatient care and customer service

Preferred Qualifications:

• Pref Certified Case Manager - CCM (CMSA) Nationally recognized certification such as CCM and/or ACM

Required Licenses/Certifications:

• Req Registered Nurse - RN (CA Board of Registered Nursing)
• Req Basic Life Support (BLS) Healthcare Provider from American Heart Association
• Req Fire Life Safety Training (LA City) If no card upon hire one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin protected veteran status disability or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance and with due consideration for patient and student safety. Please refer to theBackground Screening Policy Appendix Dfor specific employment screen implications for the position for which you are applying.

We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at or by email at. Inquiries will be treated as confidential to the extent permitted by law.

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