Hours: Mon-Fri 7am-3:30pm
Description: Duties include but are not limited to:
Perform concurrent admission and continued stay reviews according to SCKMC utilization review policy and procedure.
Perform and document discharge planning according to SCKMC discharge planning policy and procedure (by next business day in the patient's room).
Identify patients at risk for readmission and strengthen discharge plan accordingly.
Identify and utilize community resources as necessary.
Arrange for CARE Assessment when required prior to a skilled nursing facility.
Provide initial and continued stay verbal clinical reviews to insurance providers upon request to ensure pre-certification and continued stay approval for patient's hospital stay.
Provide on-line clinical review via multi-payor website (currently Availity) every business day.
Issue Medicare-required notices to beneficiaries (observation/acute inpatient/swingbed) according to CMS regulations.
Initiate Clinical Documentation Improvement (CDI) functions.
Verify chief complaint is principal diagnosis and enter in Electronic Medical Record (EMR) of each inpatient, observation patient, and outpatient surgery patient recovering on an inpatient unit.
Update problem list to reflect active problems, including complications and comorbidities (CC) and major complications and comorbidities (MCC).
Confirm History and Physical Exam report is completed within 24 hours of admission. If not, contact attending physician to complete.
Level of care (LOC)
Confirm LOC ordered is accurate according to CMS regulation and/or evidence-based criteria set. If not, consult attending physician to consider LOC change.
Confirm LOC ordered is accurately reflected in patient's registration.
Verify CMS Quality Measure screening/audit tools have been correctly initiated and protocols followed.
Complete and transmit the Minimum Data Set (MDS) for all swing bed patients timely.
Refer private pay patients to SCKMC financial counselor.
Contact discharged patients to assess general health status, confirm compliance with discharge plan, and review actions to be taken when future medical issues arise.
Advocate for patients.
License: BSN from an accredited school of nursing and Kansas state Registered Nursing licensure
Education: Maintain license by meeting KS licensing board CEU requirements (currently 30 CEU’s every 2 years.)
Experience: Three years in a like position in a like-sized facility preferred
Other: Computer literacy including word processing, spreadsheets, presentation graphic; team operation, process improvement and hospital risk management; excellent written and verbal communication skills
Human Resources Director
PO BOX 1107
Arkansas City, KS 67005