Clinical Resource Manager

Fisher-Titus Health•Norwalk, OH

2d•Onsite

About The Position

A Clinical Resource Manager is a member of the multidisciplinary team and works closely with providers, social workers, financial counselors, decision support specialists, and ancillary staff to actively facilitate those functions associated with moving the patient through an acute episode of care and linkages to community resources, internal resources, and the payer community.

Requirements

Professional degree in a healthcare discipline with current licensure to practice in Ohio
Must possess strong interpersonal skills, leadership, negotiation skills, good leadership talent, and knowledge of hospital operations.
General knowledge of the payer industry, resource management, reimbursement, and evidence based clinical practice is essential.

Responsibilities

Identify trends/problems related to delivery of care delays and potentially avoidable days through consistent data capture.
Issue Medicare adverse determination letters when deemed appropriate.
Coordinate a patient's plan of care from admission to discharge, ensuring that needs are met in a safe, timely, and cost-effective manner.
Intervene with ancillary department leadership when timely service is critical to patient's immediate needs.
Identity patients in need to intensive post-acute services.
Make referrals to social work when patient or family needs psychosocial intervention to facilitate transition planning.
Collaborate with team members to develop a transition plan appropriate to the patient's needs and ability to pay.
Patient's eligibility for post-acute services is determined within 24 hours of inpatient admission.
Serve as consultant and educator to patient and family regarding post acute service recommendations.
Serve as liaison to community resources.
Make daily rounds with assigned physician based on priorities of patient needs.
Confirm doctor's treatment plan and intended goals.
Collaborate with attending physician to establish treatment milestones to prepare patient and family for transition to lower level of care.
Initiate referrals to the appropriate areas to expedite care, treatment and services.
Utilized medical staff approved evidence based clinical protocols when patient's diagnosis warrants.
Question interventions that seem contrary to protocol and offer acceptable alternatives.
Collaborate with physician, patient and family, and nurse to identify probable post-acute needs.
During point-of-service rounds with the physician, offer suggestions for more accurate and complete documentation.