Utilization Management Assistant Jobs in Raleigh, NC

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Summary:
The Patient Admission
Officer (PAO) oversees the screening, admissions and transfer processes of patients to Advanced Care at Home through comprehensive assessment, planning and coordination. The PAO balances Advanced Care at Home and rapid response capacity with incoming admissions and transfers from multiple hospitals. The PAO actively collaborates with multiple stakeholders in the brick-and-mortar hospitals as well as clinical staff in the Advanced Care at Home. The overall goal of the position is to improve program admission efficiency/proficiency, increase program admission volumes and enhance quality.
Responsibilities:
Capacity management: Maintains continuous contact with the Advanced Care at Home clinical command center and Administrator on Call (AOC) to understand real time clinical command center and rapid response capacity to accept new patients. Monitors for operational flow of potential discharges from Advanced Care at Home and timing of home visits.
Screening, admissions and transfers: Reviews Advanced Care at Home triage Epic lists and EADS model lists each day to identify potential patients for admission or transfer. Reviews medical records to determine eligibility and maintain a comprehensive list of the potential patients. Maintains communication with frontline clinicians in the brick-and-mortar facilities. Based on known capacity and capability for Advanced Care at Home, ensures appropriate admissions and transfers from multiple hospitals. Escalates questions regarding clinical appropriateness to the Clinical Nurse Manager or Medical Director.
Communication- Collaborates with attending physicians and bedside nurses in the brick-and-mortar facilities to ensure appropriate patient selection. Make referrals to Utilization Management nurses and Physician Advisors on level of care assignment. Communicates the need for clinical and social screening completion by the virtual hospitalist and the Mission Control registered nurse. Remains available to accept patient referrals and assist with any nurse screening for potential candidates. Coordinates admitting times with the Service Coordinators and Paramedics. Serve as a point of contact for any external stakeholder inquiry pertaining to the admission of an Advanced Care at Home patient. Troubleshoots and manages conflict.
Customer service: Identify and escalate barriers to efficient, effective, patient-centric and customer-friendly service. Demonstrates flexibility and professionalism in a dynamic environment with multitasking and troubleshooting. Uses critical thinking skills to evaluate and prioritize multiple patients, working collaboratively to best accomplish the team's mission. Provides clinical support to Advanced Care at Home coworkers as needed to assure safe and timely care.
Process / Quality improvement: Participates in twice daily multidisciplinary team meetings. Attends weekly operational meetings. Attend case review meetings as needed to identify process improvement opportunities.
Other Information
Other information:
Education Requirements:
• Associates degree in Nursing (ADN) from a state-accredited school of professional nursing. BSN preferred.
Licensure/Certification Requirements:
• Licensed to practice as a Registered Nurse in the state of North Carolina.
Professional Experience Requirements:
• Three (3) years of professional nursing experience in a tertiary care setting plus one (1) year of experience managing patient flow.
Knowledge/Skills/and Abilities Requirements:
• Critical required for an individual to succeed in this position are condensed in the following areas: Familiarity with the Advanced Care at Home operations, ED triage, and hospital flow.
• Required skills: great attention to detail, exceptional communication and collaboration, fast paced critical thinking and problem solving, ability to multi task, comfort in speaking with physicians, APPs and nurses, as well as conflict resolution.
Job Details
Legal Employer: NCHEALTH
Entity: Support Operations
Organization Unit: Adv Care at Home - Command Ctr
Work Type: Per Diem
Standard Hours Per Week: 4.00
Salary Range: $38.55 - $55.43 per hour (Hiring Range)
Pay offers are determined by experience and internal equity
Work Assignment Type: Hybrid
Work Schedule: Variable
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: No
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.
Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.