Licensure, Certification, or Registration Requirements for Hire:
Licensed Registered Nurse in the State of Virginia or eligible
Licensure, Certification, or Registration Requirements for continued employment:
Current RN licensure in Virginia Complete 15 Continuing Education Units per year
Experience REQUIRED: Minimum of three (3) years of nursing experience in an acute care setting
Academic healthcare experience One (1) year of UM/Care Coordination experience Clinical experience with specialty patient population
Baccalaureate Degree in Nursing from an accredited School of Nursing
Master's Degree in Nursing or a healthcare related field from an accredited program
Independent action(s) required:
Works with the attending and consulting physicians to facilitate effective and efficient transition through the process of hospitalization.
Works collaboratively with all members of the multi-disciplinary team to ensure patient needs are met and care delivery is coordinated across the continuum, as well as appropriately reimbursed by payers as contracted, and that resources are efficiently and effectively utilized.
Seeks the expertise of social workers to resolve psychosocial patient care issues and to develop complex patient transition/discharge plans as needed. Interacts with patients, family members, healthcare professionals, community and state agencies in this effort. Serves as an advanced clinical resource to the team.
Serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information.
The role is responsible for maintaining hospital compliance with the Quality Improvement Organization (QIO) series and CMS guidelines.
Utilizes medical necessity criteria as a tool to assess appropriateness of level and setting of care, assists in the denial and appeals process, assesses quality and identifies and reports potential risk management issues.
Responsible for participation in and completion of all patient safety initiatives appropriate to the position.
The incumbent conducts all job responsibilities according to VCUHS’ Mission and Values.
Responsible for establishing and maintaining a professional rapport with providers, patients/families, and internal customers.
Supervisory responsibilities (if applicable): N/A
Additional position requirements:
Day and Evening shifts available
Age Specific groups served: All
Physical Requirements (includes use of assistance devices as appropriate):
Physical: Lifting 20-50 lbs.
Activities: Prolonged sitting, Walking (distance)
Mental/Sensory: Strong recall, Reasoning, Problem solving, Hearing, Speak clearly, Write legibly, Reading, Logical thinking
Emotional: Steady pace, Able to handle multiple priorities, Frequent and intense customer interactions, Able to adapt to frequent, change
EEO Employer/Disabled/Protected Veteran/41 CFR 60-1.4.