Shire Jobs

ESSENTIAL DUTIES AND RESPONSIBILITIES

Facilitates admissions, clinical and medical intake assessments and prior authorization process to assure continuity for the most appropriate level of care for patients. Performs assessments, screens for clinical and medical appropriateness and communicates this information to a physician who makes the appropriate level of care decision. Works closely with business office, nursing, and clinical staff as well as external parties to ensure the timely admission of patients.

Facilitates intake, admission, and prior authorization process for incoming patients.

Performs insurance benefit verifications, disseminating the information gathered to patient, their families, and appropriate internal staff.

Provides accurate and ongoing assessment of patient’s status in the admission and prior authorization process.

Facilitates the response to requests for services, including the initial response, the assessment and referral process, the designation of appropriate level of care, initiation/intake into services, and appropriate follow up activity.

Follows EMTALA regulations to complete insurance verification and precertification’s, when appropriate.

Responds to inquiries about the facility within facility policy timeframes.

Schedules/completes pre-admission assessments and communicates recommendations to patient or their family.

Uses internal bed management system to ensure accurate throughput of patients to ensure accurate bed status.

Collaborates with other facility medical and psychiatric personnel to ensure appropriate recommendations and admissions.

Performs ongoing assessments of physical/function, emotional, social, spiritual and financial needs of patients and implements crisis intervention and referral.

Provides education regarding healthcare and social resource systems to empower patient and their family to access resources independently.

Maintains all the documentation involved with the admissions process.

May have the ability to work remote in CHKDHS approved states.

Performs other duties as assigned.

LICENSES AND/OR CERTIFICATIONS

Licensure as a Registered Nurse in the state of Virginia.

BLS/CPR certification.

Master’s Degree or specialty certification in Mental Health Nursing preferred.

MINIMUM EDUCATION AND EXPERIENCE REQUIREMENTS

Graduate of accredited School of Nursing; Bachelor’s degree preferred.

Three years of relevant psychiatric experience required.

Working knowledge of DSM-5-TR diagnostic criteria, medical diagnosis, relevant lab values, mental status exam. Awareness of exclusionary criteria and ability to effectively collaborate with the psychiatry team for assessment of appropriateness of admission when needed.

Experience in the managed care pre-certification process, level of care assessments and utilization preferred.

Understanding of DNV, DBHDS, OSHA and state and federal regulatory requirements.

Must be able to prioritize workload and effectively multi-task in a fast-paced environment.

Excellent listening and communication skills.

Must be able to focus on providing high quality patient care.

WORKING CONDITIONS

Expected to work in a patient care environment with minimal exposure to environmental hazards such as, but not limited to, excessive noise, dust, or extremes in temperatures. Exposure to communicable diseases and moderately adverse working conditions due to the need to perform certain patient care activities can be expected. May be an opportunity for remote work with approved in home set up to ensure compliance.

PHYSICAL REQUIREMENTS

Click here to view physical requirements. (https://www.chkd.org/uploadedFiles/Documents/Employees/Category%20A%20Jobs.pdf%20)