Parkview Health-posted 3 months ago
Full-time • Mid Level
Fort Wayne, IN
5,001-10,000 employees
Ambulatory Health Care Services

The position involves continuously evaluating the quality, care, treatment, and outcomes of complex patient populations. The role requires collaboration with patients, families, and caregivers to facilitate necessary resources and options for post-discharge services, ensuring a safe discharge. The individual will provide consultation with physicians and other members of the interdisciplinary healthcare team to facilitate patient progression to discharge. Additionally, the position ensures that clinical documentation supports medical necessity criteria and meets regulatory requirements. Communication of the clinical status of patients related to medical necessity criteria to the physician advisor and/or the Inpatient Care Transitions leadership team is also a key responsibility. The role includes monitoring length of stay and documenting avoidable days for delay of discharge, as well as reviewing payer sources for potential negative financial liabilities to the patient.

  • Continuously evaluate the quality, care, treatment, and outcomes of complex patient populations.
  • Collaborate with patients, families, and caregivers to facilitate necessary resources and options for post-discharge services.
  • Provide consultation with physicians and other members of the interdisciplinary healthcare team to facilitate patient progression to discharge.
  • Ensure clinical documentation supports medical necessity criteria and meets regulatory requirements.
  • Communicate the clinical status of patients related to medical necessity criteria to the physician advisor and/or the Inpatient Care Transitions leadership team as needed.
  • Monitor length of stay and document avoidable days for delay of discharge.
  • Review payer source for potential negative financial liabilities to the patient.
  • Bachelor of Science in Nursing (BSN) required.
  • Valid Indiana Registered Nurse license required.
  • At least 2 years of experience in an acute care setting required.
  • Certification in Case Management highly desirable.
  • Preferred experience in Case Management activities.
  • Preferred experience or knowledge of InterQual criteria.
  • Eligible for a sign-on bonus for those who qualify.
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service