Uses skilled interventions,( objective and subjective), clinical best practice knowledge and collaboration with the patient, physician, and multidisciplinary treatment team to pace care, achieve quality outcomes and negotiate appropriate reimbursement. Ensures the timely and seamless transition of patients through medically appropriate levels of care.
Assessment: Confers with attending physician/LIP as appropriate to make determination about the medical necessity for admission or continued hospital stay. Performs assessment to determine patient care needs during the acute phase of illness and post discharge needs.
Collaboration: integrates patient information from social worker ,physician and other members of the healthcare team to collaboratively determine potential and actual risks to recovery and the next level of care Collaborates with physicians, nursing, social work, and multiple disciplines, departments, payer, agencies to eliminate barriers to efficient delivery of care in the appropriate setting
Planning: accountable for developing and coordinating the implementation of a safe and timely discharge plan and alternative plan following evidence based practice
Coordinates/facilitates : access to services and patient care progression using best practice interventions that will produce favorable patient outcomes within a target LOS
Regulatory : uses the Physician Advisor per protocol for complex issues related to physician practices, utilization review .
Documents patient interventions and outcome timely and accurately in the medical record
Required: 5 years experience working in acute care
Preferred: Experience as a community health nurse or case manager