RN Peds Behavioral Health Referral Coordinator

Corewell Health • Grand Rapids, MI

1d • Onsite

About The Position

Job Summary Provides health information, interacts and acts as a resource for nursing units for complex clinical situations to ensure appropriate use of acute care services and diagnosis-related group (DRG) management. Assesses appropriateness of inpatient admissions and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and provides financial and utilization management (UM) information to other members of the care facilitation teams for work prioritization. Works closely with inpatient care facilitators and Medical Social Workers to move patients through the continuum appropriately. Oversees the intake for the acute care behavioral health unit and ensure the completion of admission paperwork, assessment and admission navigator in Epic. As an integral part of the BH team, attends daily team meetings, shares covered days for LOS determinations and has timely follow-up with insurance providers to gain extended stay coverage as needed. Participates in community relations development and process improvement, to include Riverwood and other local mental agencies. Essential Functions Oversees intake for the acute care behavioral health unit. Complete admissions paperwork, skin assessments, and physical assessments. Provides information and background to the assigned nurse about the new patients and communicating their needs including medication, special safety observation, and withdrawal protocol. Answers basic questions from patients and guardian regarding their admission and the unit. Interview new patients with patience and sympathy, while completing the admission navigator in Epic, including care planning, treatment planning, and progress notes, in a timely manner. Educating patients/guardian on their admission status (involuntary vs voluntary) and the unit schedule, rules, and regulations (including contraband rules). Is an integral part of the BH team, attends daily team meetings, shares covered days for LOS determinations and has timely follow-up with insurance providers to gain extended stay coverage as needed. Collaborates with internal and external sources to assure admission criteria, checklist, and legal documents for appropriateness. Assesses and interprets clinical information and assists in case management of complex patient population, through use of independent judgment, mature problem solving skills, and guidelines for appropriateness of acute care setting upon admission and continued stay. Adjusts patient registration status code, as needed, to maximize reimbursement and be consistent with regulatory standards. Communicates with physicians, medical social workers, and other hospital personnel concerning change in level of care on the medically complex patient population. Makes recommendations and discusses alternatives. Provides financial/DRG, UM, health information to other facilitation team members for work prioritization. Communicates and collaborates with physicians and members of the team to ensure continuity and coordination of services. Documents any instances where services were delayed, inappropriate, refused, complicated, etc. for resource management functions. Identifies quality indicators to facilitate process improvement and physician education. Coordinates with care management on admissions, on-going stay UM workflows, authorization, denial, and appeal process. Participates in community relations development and process improvement, to include Riverwood and other local mental agencies.

Requirements

• Associate's Degree Nursing
• 2 years of relevant experience acute care, clinical nursing, preferably multiple clinical settings, or related experience
• LIC-Registered Nurse (RN) - STATE_MI State of Michigan required

Nice To Haves

• Bachelor's Degree Nursing

Responsibilities

• Oversees intake for the acute care behavioral health unit.
• Complete admissions paperwork, skin assessments, and physical assessments.
• Provides information and background to the assigned nurse about the new patients and communicating their needs including medication, special safety observation, and withdrawal protocol.
• Answers basic questions from patients and guardian regarding their admission and the unit.
• Interview new patients with patience and sympathy, while completing the admission navigator in Epic, including care planning, treatment planning, and progress notes, in a timely manner.
• Educating patients/guardian on their admission status (involuntary vs voluntary) and the unit schedule, rules, and regulations (including contraband rules).
• Is an integral part of the BH team, attends daily team meetings, shares covered days for LOS determinations and has timely follow-up with insurance providers to gain extended stay coverage as needed.
• Collaborates with internal and external sources to assure admission criteria, checklist, and legal documents for appropriateness.
• Assesses and interprets clinical information and assists in case management of complex patient population, through use of independent judgment, mature problem solving skills, and guidelines for appropriateness of acute care setting upon admission and continued stay.
• Adjusts patient registration status code, as needed, to maximize reimbursement and be consistent with regulatory standards.
• Communicates with physicians, medical social workers, and other hospital personnel concerning change in level of care on the medically complex patient population.
• Makes recommendations and discusses alternatives.
• Provides financial/DRG, UM, health information to other facilitation team members for work prioritization.
• Communicates and collaborates with physicians and members of the team to ensure continuity and coordination of services.
• Documents any instances where services were delayed, inappropriate, refused, complicated, etc. for resource management functions.
• Identifies quality indicators to facilitate process improvement and physician education.
• Coordinates with care management on admissions, on-going stay UM workflows, authorization, denial, and appeal process.
• Participates in community relations development and process improvement, to include Riverwood and other local mental agencies.

Benefits

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here .
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance, pet insurance
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees