Registered Nurse-Inpatient Care Coordinator (Days/Nights), Sitka, AK

Mobile Health Team Inc

2d•$59•Onsite

About The Position

Mobile Health Team Inc. is seeking an experienced Registered Nurse-Inpatient Care Coordinator for a 13-week travel assignment in Sitka, AK. This role involves managing patient progression of care, promoting evidenced-based protocols, ensuring the appropriateness of interventions, and expediting care delivery for admitted patients. The position also directs patient care services to ensure timely and appropriate patient discharge.

Requirements

Must have 8 years’ clinical care or nursing experience, 3 years of which should be in chart review, risk management, or related quality service
Active nursing license in Alaska required.
High school diploma or equivalent required.
Excellent problem-solving and critical thinking skills
Strong organizational skills and ability to multitask
Willingness to participate in continuing education and training programs
Strong attention to detail and ability to work independently
Strong communication, professionalism, and reliability
Drug screen and background check (facility required)
Additional facility onboarding forms as assigned

Nice To Haves

Case Management certification by recognized certifying organization (i.e., NCQA, CCMC) preferred.

Responsibilities

Reviews patients’ records and evaluates patient progress.
Performs continuing review of the patient hospitalization to monitor the necessity for specifically and appropriateness of hospitalization, length of stay, and quality of care.
Provides UM and review functions to the Purchased/Referred Care Services program for beneficiary patients admitted to other facilities.
Obtains and reviews necessary medical reports and treatment plans as requested by regulatory agencies or payers.
Reviews and validates physician orders, reports progress and unusual occurrences on patients.
Works with the leadership, clinical care team and physicians to ensure healthcare services are appropriate and cost-effective.
Collaborates with physicians, leadership, and the clinical care team to ensure adherence to the UM/CM/DCP plan.
Reviews new hospital admissions to assess patient condition(s) and needs in order to develop personalized treatment plans.
Provides appropriate or required information to patients and/or their families regarding their healthcare benefits.
Reviews patient records and participates in interdisciplinary collaboration with professional staff.
Ensures maintenance of the Utilization Review Plan collaboration with the Utilization review staff Medical Director (or designated provider).
Facilitates educational programs and advises physicians and other departments of regulations affecting UM/CM/DCP.
Directs the coordination of patient care departments, ensuring treatment plans are based on the need of the patient and meet criteria approved by the hospital and any regulatory or payer requirements.
Ensures documentation supports the UM functions and communicates with payers within required timeframes.
Reviews information, communicates results to claims adjusters, and enters billing information appropriate.
Prepares information for notification letters providers, staff, and patients.
Received and processes request for appeal of denials.
Responds to complaints per UM review guidelines.
Maintains utilization review and appeal logs.
Supports clinical improvements activates by providing quality review.
Performs tumor registry functions.
Other duties as assigned.