RN Patient Flow & Throughput Util & App Spc (2702)

Hurley • Flint, MI

20h • Onsite

About The Position

The Patient Flow and Throughput Utilization and Appeals Specialist operates with an effort to eliminate clinical barriers to acute progression of care and post-acute discharge planning while aligned with the mission of the organization. This registered nurse role supports the Care Coordination department throughout the medical center in addressing and resolving insurance issues related to access to DME, medications, levels of care post-acute, and appeals for services. Key responsibilities include building and maintaining relationships with physicians and clinical staff so as to bridge the gap between them and the payer matrices as needed to support throughput and reimbursement for the organization. Requires strong clinical knowledge and judgment. Serves as the primary liaison between operational areas and appeals processes related to progression of care. Participates in quality assessment and continuous quality improvement activities. Works independently and incorporates positive patient experience tools and practices into their daily workflows. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior.

Requirements

• Registered Nurse (RN)
• Strong clinical knowledge and judgment
• Ability to work independently

Responsibilities

• Eliminate clinical barriers to acute progression of care and post-acute discharge planning.
• Support the Care Coordination department in addressing and resolving insurance issues related to access to DME, medications, levels of care post-acute, and appeals for services.
• Build and maintain relationships with physicians and clinical staff to bridge the gap between them and the payer matrices.
• Support throughput and reimbursement for the organization.
• Serve as the primary liaison between operational areas and appeals processes related to progression of care.
• Participate in quality assessment and continuous quality improvement activities.
• Incorporate positive patient experience tools and practices into daily workflows.
• Perform all job duties and responsibilities in a courteous and customer-focused manner.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level