Location: Chicago, IL
Hospital: RUSH University Medical Center
Department: Care Management
Work Type: Restricted Part Time (Total FTE less than 0.5)
Shift: Shift 1
Work Schedule: 8 Hr
Summary:
The Clinical resource coordinator (CRC) applies a collaborative approach in working with physicians, patients, case managers, community providers, payers and internal/external agencies to provide case management support services related to effective utilization of services and transition planning for adult, geriatric, neonate, pediatric and adolescent patients. CRC activities and processes include patient interviews, screenings, referrals, follow-up calls, discharge planning, payer certification, denial avoidance and customer satisfaction. CRC services may be coordinated centrally through department or assigned by unit, physician practice or Case Management service line. Responsibilities for specific liaison roles may vary depending upon assignment. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.
Responsibilities:
• Manages caseload, serves as resource, sets priorities and completes assigned tasks.
• Facilitates collaboration with CM team/department to prioritize tasks, ensuring department support needs are met.
• Models ICARE values and actively supports teamwork, customer service and employee engagement. Flexes schedule to meet department needs.
• Facilitates effective, efficient communication and problem solving with internal and external customers.
• Uses information technology to document activities, track performance outcomes and produce performance reports.
• Provides training and orientation, creates reference materials and shares expertise with others.
• Seeks continuing education opportunities, completes required in-services and maintains professional growth by attending various department, institutional and external meetings, seminars and
workshops.
• Applies performance improvement strategies to promote continuous process improvement.
• Identifies opportunities and collaborates with CM team/department to implement solutions.
• May serve on department or hospital-wide committees as needed.
• Collaborates with team, department, unit staff, and/or physician practice to ensure expectations are met.
• Performs activities in support of patient flow that may include patient placement activities.
• Provides services that may include but limited to: patient centered interviews, transitions in care screenings, identification of potential post discharge needs and the presentation of patient resource folder and documentation of findings.
• Facilitates communication with Case Manager and team: Supports processes related to care transitions including discharge central and/or unit/team centered provider referral communications. Meets customers' varied needs by readily providing support including, but not limited to, faxing and copying forms.
• Ensures compliance with HIPPA and ROI regulations and protocols.
• Manages Medicare Important Message processes and related tasks.
• Works with CM and Patient Access to ensure hospital compliance with federal mandates.
• Coordinates post discharge care transition referral communication.
• In collaboration with the case manager, provides referral and follow-up contacts to agencies, facilities and patients/families to support safe, effective care transitions.
• Identifies issues, resolves when able, triages to the appropriate level and collaborates with case managers, senior case managers, nurses, physicians and general staff throughout the medical center to
resolve care transition issues.
• Provides designated support for functions including payer approval / certification communication, denial appeals, and / or level of care management processes.
• In accordance with the case management external faxing policy and HIPPA guidelines, communicates clinical information/PHI to payers to ensure certification of inpatient hospital stays via secure e-fax.
• Contacts payers to obtain or confirm fax and contact information for certification nurses.
• Follows protocols and HIPPA compliance regulations and proposes process improvements to managers when issues are identified.
• Follows protocol and reports known or suspected misdirected fax incidents to certification supervisor/manager. Provides level of care support services for certification, denial and/or preadmission LOC
management teams, including monitoring reports, paging/texting physicians, checking EPIC documentation and other assigned tasks.
• Conducts preadmission and post admission screening and interviews, provides patient/family education at scheduled classes and handles follow-up calls and communication with physician practice(s)
care team as warranted.
Other information:
Required Job Qualifications:
• High School Diploma and two years' experience.
• Demonstrated knowledge and/or experience with hospital - related service functions such as: patient interviews, discharge planning/social service basic assessment and referral processes, community resources, finance and payer communication processes and information systems.
• Excellent written and verbal communication and interviewing skills.
• Expertise with information systems and Microsoft Office Suite and ability to create reports/communication documents related to role and outcome performance monitoring.
• Ability to communicate effectively with health care team, patients/families and community, internal and external providers to promote effective transitions in care.
• Commitment to teamwork, collaborative approach and customer service focus desired.
• Ability to perform tasks independently, seek direction as needed and prioritize workload.
• Flexibility to adjust schedule and assignment as workload warrants; including weekends.
Preferred Job Qualifications:
• Bachelor’s Degree (health related or equivalent area of focus such as social work, psychology or medical terminology).
Disclaimer: The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.
Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
