RN Care Command - Command Center, Nights

Phoebe Putney Health System•Albany, GA

About The Position

The Access Care Manager (CM) manages the entry and coordination of patients into the hospital, including planning, execution, and management of bed placement for admissions from all entry points, such as the emergency center, direct admissions, and transfers. The role follows Phoebe Putney Memorial Hospital’s clinical standards and guidelines, performs admission clinical reviews to determine appropriate level of care and patient status, and ensures patients are placed in the most appropriate available bed for their clinical needs using established admission criteria. Patient transfers must comply with EMTALA regulations and guidelines. The Access CM works with care management, nursing, physicians, and other disciplines to support appropriate placement and admission status. The role performs utilization review, documents reviews and related activity in electronic systems, applies approved clinical criteria and payer requirements, and escalates questions or cases when needed. The Access CM also supports education, teamwork, performance improvement, patient flow, and efforts to identify and address readmission trends. The position requires an Associate Degree in Nursing, a current Georgia RN license, AHA Basic Life Support certification, and three years of progressive clinical and basic management experience. A Bachelor’s Degree in Nursing is preferred.

Requirements

Associate Degree in Nursing required.
Three years of progressive clinical and basic management experience required.
Registered Nurse (RN) with a current Georgia license.
AHA Basic Life Support (BLS) certification.
Ability to communicate effectively and build teams.
Ability to maintain patient confidentiality and follow applicable hospital and department policies.
Knowledge of EMTALA regulations and ability to apply them consistently within the scope of the role.
Ability to apply clinical criteria, utilization review requirements, and payer standards to admission and transfer reviews.
Ability to document utilization review activity accurately, clearly, and promptly in electronic systems.
Ability to work with minimal day-to-day direction, learn and apply new skills, and serve as a resource to others.

Nice To Haves

Bachelor’s Degree in Nursing preferred.

Responsibilities

Manage patient entry and coordination into the hospital, including planning and managing bed placement for admissions from all entry points.
Perform admission clinical reviews to determine appropriate level of care and patient status, and place patients in the most appropriate available bed according to established criteria.
Ensure patient transfers follow EMTALA regulations and guidelines.
Communicate with care management, nursing, physicians, and other disciplines about patient placement and admission status.
Maintain patient confidentiality and follow hospital and department policies and work instructions.
Apply current federal, state, accreditation, and payer requirements relevant to utilization review and admission or transfer processes.
Educate physicians and others about regulatory and payer issues that affect admission or transfer.
Perform utilization review functions and document reviews, referrals, follow-up, activities, and outcomes accurately and promptly in the appropriate electronic system.
Apply medical-staff-approved clinical criteria and payer standards to reviews; review transfer and admission documents and discuss level-of-care questions with the admitting physician or designee.
Refer medical necessity questions to a physician advisor and escalate cases to the Team Lead or Director of Care Management when guidance or administrative support is needed.
Provide timely notification to the admitting physician and review payer information for authorization requirements that could affect patient or hospital liability, referring matters to the appropriate area.
Educate staff, physicians, and patients about the Access Care Manager role; contribute to teamwork, committees, projects, and professional practice.
Identify and implement strategies to improve care coordination, efficiency, patient flow, and hospital operations.
Identify readmission patterns and trends, assess potential causes, and refer patient-specific issues to appropriate care team members to help prevent future readmissions.
Incorporate evidence-based knowledge into practice and participate in quality improvement activities.
Follow attendance and punctuality guidelines; uphold the organization’s core values, mission, and vision; and perform other duties in accordance with department policies and procedures.
Maintain current knowledge through self-education and ongoing educational programs; attend staff meetings and complete mandatory training, in-services, and competency evaluations on time.
Demonstrate competency in providing care to patients based on age, sex, weight, and demonstrated needs; for non-clinical areas, use age-specific customer service skills.
Wear protective clothing and equipment as appropriate.