Job Description

Job Overview:

This position provides comprehensive care coordination for patients as assigned, including initiation and coordination of incoming and outgoing transfers for higher/lower level of care and/or specialized treatment modalities from outreach or network entities. This position secures required specialists and/or following physician s assessment and triage for appropriate level of care, financial assessment and referral. This position also carries out market strategies to obtain referral of clients from third party payers and physicians in liaison role.

Qualifications:

Required:

• Requires an active BSN RN license in state of practice, temporary RN license in state of practice, or compact RN licensure for current state of practice
• Critical Care Experience (ALS/PALS/BLS), requires knowledge typically achieved with three years of experience in the care of the population served, as well as experience in clinical care operations, case management and/or patient throughput
• Must have a working knowledge of hospital operations, medical/nursing staff procedures, hospital and community resources
• Must demonstrate critical thinking, conflict resolution, time management, and problem-solving skill
• Requires excellent communication skills and an ability to interact well across departments, facilities and organizations
• Excellent organizational and human relations are required to maintain good rapport and effective working relationships with internal and external customers

Preferred:

• Expert level of Microsoft Office
• Bachelor's degree in nursing or healthcare related field
• Additional related education and/or experience
• The ability to accurately type at least 40 wpm

Certifications and Licenses Required:

• An active BSN RN license in state of practice, temporary RN license in state of practice, or compact RN licensure for current state of practice

Scheduling Requirements:

• Provide 10 shifts of availability per calendar quarter submitted in the scheduling portal by the 15th of the previous month
• Must work 6 of the 10 shifts submitted
• 12 hour shifts

Essential Functions :

• Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes. Assesses patient admissions and continued stay, utilizing standard criteria.

• Facilitates patient throughput to a final destination facility with an ongoing focus on quality and efficiency

• Coordinates patient placement among multiple outreach and network facilities for admissions and transfers. Coordinates safe patient transfers according to established operational processes and guidelines in place for all service lines at each facility. Alerts staff at appropriate entity/agency of incoming/outgoing patients, scheduling bed/services, performs clinical and financial screening of referred patients and coordinates transportation. Serves as a liaison with other departments, leaders and presiding physicians regarding process improvement opportunities for patient flow, patient transfers and efficacy of communication process.

• Manages individual patients across the healthcare continuum to achieve the optimal clinical, financial, operational and satisfaction outcomes. Serves as a liaison for the continuum of care including preadmission, hospitalization, depending on work assignment.

• Maintains process for assessing current referral patterns for selected target areas by identifying physician referral patterns, health related community events, established physician practices and major gatekeepers in outreach and network communities. Establishes and promotes collaborative relationships with physicians, payers and other members of the healthcare team, including non-RWJBH entities. Seeks opportunities to increase the growth of business within the assigned communities, identifying and cultivating potential referral sources relevant to the population served.

• Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. Provides outcome data with targeted audiences including physicians, medical case managers, rehabilitation professionals, insurance adjustors and industrial representatives.

• Serves as a resource to other staff members and promotes a collegiality between staff physicians and leaders. Participates in interdisciplinary healthcare teams to facilitate the integration of managed care concepts within the daily practice standards. Acts as a consultant within the organization and in the community.

• May supervise staff depending on work assignment.

• Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks and participating in professional societies.

• This position has regional responsibility for placement and coordination of care for patients. Internal customers include all levels of nursing leadership and staff, medical staff and all other members of the interdisciplinary healthcare team. External customers may include patients and families, physicians, agency vendors and contracted services, staff from other health care agencies/providers and community/professional organizations and community and regulatory agencies.

• Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards. Provides all customers of RWJBH with an excellent service experience by consistently demonstrating our core and leader behaviors each day.

• After onboarding proficient in running Central Logic database, telephone systems with call recording, and / or Bed Management/Registration systems and office-oriented systems as required supporting client operations.

• Proficient technical ability to simultaneously manage multiple complex computer systems at a speed reflective of patient acuity needs. Able to meet the agent productivity standards as set by Transfer Center Leadership

• Demonstrates knowledge of regulatory requirements such as EMTALA, Compliance policies, quality initiatives, and HIPAA laws and regulations; monitors self-compliance and implements process changes to ensure compliance to such regulations and quality initiatives. Ensures that appropriate standards of practice follow corporate compliance guidelines, acts in and ethical and legal manner, and assures that all actions are in the best interest of RWJBH system

• NOTE: The core functions are intended to describe the general content of and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent's immediate manager.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Additional Information:

Choosing RWJBarnabas Health!

RWJBarnabas Health is the premier health care destination providing patient-centered,high-quality academic medicine in a compassionate and equitable manner, while delivering a best-in-class work experience to every member of the team. We honor and appreciate the privilege of creating and sustaining healthier communities, one person and one community at a time. As the leading academic health system in New Jersey, we advance innovative strategies in high-quality patient care, education, and research to address both the clinical and social determinants of health.

RWJBarnabas Health aims to truly make a unique impact in local communities throughout New Jersey. From vastly improving the health of local residents to creating educational and career opportunities, this combination greatly benefits the state. We understand the growing and evolving needs of residents in New Jersey whether that be enhancing the coordination for treating complex health conditions or improving community health through local programs and education.

Equal Opportunity Employer

RWJBarnabas Health is an Equal Opportunity Employer

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