Location
Falls Church, VA | United States
Job description
Position Summary:
- Care for ill, injured, or convalescing patients or persons with disabilities in hospitals, nursing homes, clinics, private homes, group homes, and similar institutions.
- May work under the supervision of a registered nurse. Licensing required.
Reports To: - Contracted Medical Facility's onsite Nurse Manager/Supervisor, Physicians
- Cynet Health Account Manager
- Cynet Health Director of Nursing
Duties and Responsibilities: - Performs admission, concurrent, and retrospective reviews on all patients.
- Ensures that status and level of care determination are accurate upon admission.
- Ensures that pre certifications/authorizations are obtained and documented appropriately for all admissions, surgeries, and procedures.
- Follows Medicare guidelines regarding utilization review.
- Submits telephonic and/or fax notification/clinical information
- Follows up with insurer for authorizations.
- Identifies potentially high risk patients and refer to Social Work.
- Provides coaching to physicians as needed regarding effective clinical documentation Conducts Initial Assessments to develop plan of care.
- Ensures that treatment plan is implemented, re-evaluated, and updated daily
- Facilitates effective communication between members of the treatment team
- Coordinates meetings w/ families and treatment team
- Facilitates arrangement of post-acute care services
- Acts as an advocate for the patient/family
- Follows Medicare guidelines regarding patient choice, admit/discharge notifications, and appeals.
- Maintains accountability for facilitating clinical patient progression through a defined plan of care to achieve optimal outcomes.
- Identifies, document, and report quality, cost, and risk variances related to patient's plan of care.
Minimum Job Requirements: - Graduate of an accredited school of nursing, with current licensure in state practicing in
- good standing in the state of practice.
- Evidence of minimum two years of current hospital experience.
- Evidence of current BLS credential mandatory.
Job tags
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