Job Summary
Provides health information interacts and acts as a resource for nursing units for complex clinical situations to ensure appropriate use of acute care services and diagnosis-related group (DRG) management. Assesses appropriateness of inpatient admissions and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and provides financial and utilization management (UM) information to other members of the care facilitation teams for work prioritization. Works closely with inpatient care facilitators and Medical Social Workers to move patients through the continuum appropriately. Oversees the intake for the acute care behavioral health unit and ensure the completion of admission paperwork assessment and admission navigator in Epic. As an integral part of the BH team attends daily team meetings shares covered days for LOS determinations and has timely follow-up with insurance providers to gain extended stay coverage as needed. Participates in community relations development and process improvement to include Riverwood and other local mental agencies.
Essential Functions
- Oversees intake for the acute care behavioral health unit. Complete admissions paperwork skin assessments and physical assessments.
- Provides information and background to the assigned nurse about the new patients and communicating their needs including medication special safety observation and withdrawal protocol.
- Answers basic questions from patients and guardian regarding their admission and the unit.
- Interview new patients with patience and sympathy while completing the admission navigator in Epic including care planning treatment planning and progress notes in a timely manner.
- Educating patients/guardian on their admission status (involuntary vs voluntary) and the unit schedule rules and regulations (including contraband rules).
- Is an integral part of the BH team attends daily team meetings shares covered days for LOS determinations and has timely follow-up with insurance providers to gain extended stay coverage as needed.
- Collaborates with internal and external sources to assure admission criteria checklist and legal documents for appropriateness.
- Assesses and interprets clinical information and assists in case management of complex patient population through use of independent judgment mature problem solving skills and guidelines for appropriateness of acute care setting upon admission and continued stay.
- Adjusts patient registration status code as needed to maximize reimbursement and be consistent with regulatory standards.
- Communicates with physicians medical social workers and other hospital personnel concerning change in level of care on the medically complex patient population. Makes recommendations and discusses alternatives. Provides financial/DRG UM health information to other facilitation team members for work prioritization. Communicates and collaborates with physicians and members of the team to ensure continuity and coordination of services.
- Documents any instances where services were delayed inappropriate refused complicated etc. for resource management functions.
- Identifies quality indicators to facilitate process improvement and physician education.
- Coordinates with care management on admissions on-going stay UM workflows authorization denial and appeal process.
Participates in community relations development and process improvement to include Riverwood and other local mental agencies.
Qualifications
- Required Associates Degree Nursing
- Preferred Bachelors Degree Nursing
- 2 years of relevant experience acute care clinical nursing preferably multiple clinical settings or related experience Required
- LIC-Registered Nurse (RN) - STATEMI State of Michigan required
How Corewell Health cares for you
Comprehensive benefits package to meet your financial health and work/life balance goals. Learn more here.
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you like restaurants phone plans spas and more!
Optional identity theft protection home and auto insurance pet insurance
Traditional and Roth retirement options with service contribution and match savings
Eligibility for benefits is determined by employment type and status
Primary Location
SITE - Helen Devos Childrens Hospital - 100 Michigan St - Grand Rapids
Department Name
Pediatric Care Unit Behavioral Health 11th Fl HDVCH - Grand Rapids Hosp
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8am-4:30pm
Days Worked
Monday to Friday
Weekend Frequency
Every other weekend
CURRENT COREWELL HEALTH TEAM MEMBERS Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members patients visitors and community. We require a drug-free workplace and require team members to comply with the MMR Varicella Tdap and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process to perform the essential functions of a job or to enjoy equal benefits and privileges of employment due to a disability pregnancy or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race color national origin sex disability age religion genetic information marital status height weight gender pregnancy sexual orientation gender identity or expression veteran status or any other legally protected category.
An interconnected collaborative culture where all are encouraged to bring their whole selves to work is vital to the health of our organization. As a health system we advocate for equity as we care for our patients our communities and each other. From workshops that develop cultural intelligence to our inclusion resource groups for people to find community and empowerment at work we are dedicated to ongoing resources that advance our values of diversity equity and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.