Overview Plans, coordinates and directs quality care by maintaining standards of professional nursing practice and creating positive relationships with patients/families in the physician clinic. Provide professional nursing care for these patients according to established standards and practices. Assist with the overall operations of the clinic to include the work environment including assuring that appropriate clinical policies and procedures are in place and followed. Work within scope of practice allowable by licensing and/or certification board. Responsibilities Assesses condition of each clinic patient, which may include, but not limited to: the patient’s physical condition, psychological status, social status, spiritual and cultural needs, pain assessment/management, nutritional and functional status, developmental or age related factors, and other needs. Assist physician(s) and/or nurse practitioner with developing and implementing a comprehensive clinical environment for the identification, evaluation, and treatment of patients in the Clinic Assist physician(s) and/or nurse practitioner with care and follow up of all patients Assist with all applicable testing of patients - as ordered by physicians and/or nurse practitioner. Provide additional nursing care in the clinical setting as directed by the physicians and/or nurse practitioner Prepare exam/treatment rooms with necessary equipment. Assist physicians and/or nurse practitioner with patient exams, procedures, tests, treatments and minor procedures Administer medications and treatments as directed by physicians and/or nurse practitioner according to scope of approved clinic practices. Instruct patient in collection of samples, testing, procedures, and follow up care. Schedule follow up appointments, exams, and tests as needed. Instruct patient and/or family regarding medications and follow-up care. Screen and respond to triage calls and ensure follow-up by nurse or physician and/or nurse practitioner. Clean and stock rooms as scheduled Review the patients that have tests due or that are overdue to insure that all ordered test are done. Notify the appropriate provider if the patient does not have the ordered test completed. Assist with management of the clinic including developing and implementing policies and procedures to ensure a safe environment for staff and patients Attend required professional and clinical meetings. Maintain patient privacy in all matters including written medical records and computer records. Assist with day to day operations of the clinic including but not limited to answering the phone, organizing charts, ordering supplies, etc. DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Performs compliance requirements as outlined in the Employee Handbook Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self. Performs essential job functions in a manner that ensures the safety of patients, visitors and employees. Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees. Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees. Requires use of electronic mail, time and attendance software, learning management software and intranet. Must adhere to all DCH Health System policies and procedures. All other duties as assigned. Qualifications RN requirements: Associate’s or Bachelor’s Degree from RN program with current Alabama licensure in good standing from the Alabama Board of Nursing. Prior work experience in outpatient primary care or other physician clinic - preferred Ability to operate basic office equipment. Excellent verbal communication skills to interact with patients, coworkers and other visitors. Must be able to read, write legibly, speak, and comprehend English. WORKING CONDITIONS Requires manual dexterity. Position is in a clinic setting requiring mostly standing, reaching, bending, and stooping during the course of each day. Occasionally requires lifting up to 40 pounds from floor to shoulder level. May require use of footstool to reach top shelves. The position includes exposure to human body fluids, disease, infection, lab chemicals and hazard material. The position requires wearing common protective or safety equipment. The position requires good communication skills, involves contact either face to face, by email or over the phone with co-workers, physicians, and patients. Physical presence onsite of essential. Hearing and vision must be normal or corrected to within normal range. Able to perform the duties with or without reasonable accommodation.
Overview Evaluates patients for appropriateness of admission type and setting, utilizing a combination of clinical information, medical necessity standards, and/or and InterQual guidelines. The Utilization Review Nurse utilizes clinical knowledge to support the coordination and documentation and communication of medical services and/or benefits. The Utilization Nurse also serves on the liaison between the physicians, patients, payers and care managers regarding termination of benefits, denial notification, and expedited appeals. Has access to highly sensitive, confidential information. Responsibilities Evaluates medical records for appropriateness of admission status utilizing a combination of clinical information, screening criteria, and third party information. Collaborates with business office, care managers, attending physicians, and physician advisors as needed. Works with Patient Registration\Financial Counselor (s) to identify correct insurance source and proper billing. Verifies patient admission information for each assigned patient within 24 hours of patient’s admission (next business day) or per payer guidelines. Collaborates with the Case Manager to identify referrals to Financial Counselors. Negotiates resolution of disagreements over the need for acute hospital level of care with the insurer. Educates staff and physicians about managed care principles, observation status, and reimbursement rules. Maintains records in a complete, detailed, and orderly manner. Identifies Potential Avoidable Days per department policy. Conducts self-auditing of medical records for status accuracy and provides peer consultation regarding cases in which patients are failing to progress and/or experiencing significant deviation from the plan of care. Collaborates with case managers and social workers for patients with complex, clinical, financial and psycho-social needs. Reviews physician orders and patient progression and intervenes with care coordination as needed. Collaborates with other departments to eliminate barriers, as necessary. Builds trusting relationships with attending physician, patient and/or family and other members of the healthcare team. Establishes a caring relationship with patients and their caregivers, promotes patient engagement and guides patients/families through the transition phase Gathers information for statistical monitors, plus special projects within the Care Management Department. Updates and documents in Expanse and Cortex, pertinent clinical information by utilizing screening criteria and assigns next review date. Responsible to support and participate in department strategies and efforts focused on improving length of stay (LOS) and reduction of avoidable readmissions. Responsible to support and participate in department strategies and efforts focused on improving clinical documentation by physicians. Identifies and reports Quality and Risk Management concerns and enters risk events in Midas. Is knowledgeable of hospital mission, vision, and values and performs in a manner to support them. Reviews an average of 25 patients per day. Delivers denial letters from all payers to the beneficiary or proper representative; explain appeal rights. Must be able to successfully complete the Interrater Reliability Tool for InterQual Level of Care Acute Criteria. (Adult and Pediatric) after successful orientation. DCH Standards Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Performs compliance requirements as outlined in the Employee Handbook Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self. Requires use of electronic mail, time and attendance software, learning management software, and intranet. Must adhere to all DCH Health System policies and procedures. All other duties as assigned. Qualifications Anyone hired after July, 2011 must meet the following: Minimum of Registered Nurse with current Alabama license. Minimum 2 years experience as an RN preferred. Minimum of at least 2 years as care management and/or utilization management experience preferred. Minimum of 2 years of Med Surgical experience preferred; Utilization Review experience preferred. Expected to work under minimal management supervision Efficient use of basic computer skills Ability to multi task, prioritize and effectively adapt to a fast paced changing environment Sedentary work involving periods of sitting, talking, and listening. Work requires sitting for extended periods, talking on the phone, and typing on the computer. Work requires the ability to perform close inspection of computer generated documents as well as a PC monitor. Typical office working environment with productivity and quality expectations. Ability to establish priorities, meet deadlines, and maintain proper productivity. Ability to form positive, collaborative relationships with hospital staff, patients, families, and payers. Ability to problem solve in a proactive, creative manner, using sound judgment based on factual information and clinical knowledge. Ability to effectively negotiate with internal and external providers of patient care services. Ability to develop leadership skills and to serve as a role model for clinical staff. Ability to actively participate in multidisciplinary teams. Ability to work independently or within a team structure. Excellent interpersonal skills, communication style, and organization. Must be able to read, write legibly, speak, and comprehend English. WORK CONTEXT Ability to form positive, collaborative relationships with physicians, colleagues, hospital staff, patients, families, and external contacts. Ability to provide guidance and direction to subordinates, including performance standards and monitoring performance. Ability to encourage and build mutual trust, respect, and cooperation among team members. Ability to communicate with people outside the organization and represent the organization to the public, government, and other external sources. Ability to work independently or within a team structure. May be exposed to environmental cleaning chemicals PHYSICAL FACTORS Requires Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work. Ability to tolerate prolonged periods of sitting or standing and/or walking. Ability to reach reasonable distances to handle equipment. Good manual and finger dexterity. Must be able to perform the duties with or without reasonable accommodation. Hearing and vision must be normal or corrected to within normal range. Physical presence onsite is essential.
Overview Plans, coordinates and directs quality, compassionate care by maintaining standards of professional nursing practice and creating positive therapeutic relationships with patients/families. . Supervises LPNs, PCAs, PCAs/US, US, Ortho Techs and other non-licensed staff. Responsibilities Assesses condition on each assigned patient on admission and on an ongoing basis to include but not limited to the patient’s physical condition, psychological status, social status, spiritual and cultural needs, pain assessment/management, nutritional and functional status, developmental or age related factors, and discharge planning needs. Plans, provides, and documents patient and/or significant other education based on physical, behavioral, psychological, developmental, and age-related factors, after identifying barriers to learning. Evaluates and regularly reevaluates patient care; coordinates care planning with patient, family, providers and other disciplines to achieve patient-centered outcomes. Assigns and delegates nursing care to team members in accordance with the patient’s needs and the capabilities of the team members. Applies safety principles when performing care Accurately documents observations, care provided, and changes in care plan. Provides accurate handoff reports and participates in unit based huddles Assists in performance improvement (PI) activities by serving on PI teams as warranted, assisting with PI measures and supporting and implementing changes necessary for improvement. Performs initial and annual competency per job class. DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Performs compliance requirements as outlined in the Employee Handbook Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self. Performs essential job functions in a manner that ensures the safety of patients, visitors and employees. Identifies and reduces unsafe practices that may result in harm to patients, visitors and employees. Recognizes and takes appropriate action to reduce risks and hazards to promote safety for patients, visitors and employees. Requires use of electronic mail, time and attendance software, learning management software and intranet. Must adhere to all DCH Health System policies and procedures. All other duties as assigned. Qualifications Current Alabama RN license required. Current American Heart Association (AHA) Basic Life Support (BLS) Provider training required. Must be able to read, write legibly, speak, and comprehend English. Acute Care – Current American Heart Association (AHA) Basic Life Support (BLS) required. Cardiac/Critical Care – Current AHA BLS and AHA ACLS required. Emergency Department – Current AHA BLS, AHA ACLS, Pediatric Advanced Life Support (PALS), and Trauma Nursing Core Course (TNCC). Perioperative – Current AHA BLS and AHA ACLS required. Additionally: PACU – AHA PALS required Prep & Discharge/Post-Surgical – Does not require ACLS. Rehab – Current AHA BLS required. Women’s/Children – Current AHA BLS required. Additionally: NICU – Current AHA Neonatal Resuscitation (NRP) and STABLE Program required. Labor & Delivery – Current AHA ACLS, AHA NRP, and Intermediate Fetal Monitoring required. Mother Baby Unit – Current AHA NRP, and STABLE Program required. Pediatrics – Current AHA PALS required. Clinical Support – Current AHA BLS required. Additionally: Cardiac Monitoring Unit – Current AHA ACLS required. North Harbor – Current AHA BLS required. Working Conditions WORK CONTEXT Demonstrate leadership skills Requires decision making that will affect others Responsible to achieve outcomes Must be able to communicate clearly and accurately Ability to delegate to team members and students Must be able to receive delegation Address conflict and stressful situation Communicate with different personalities and engage in face to face discussion Dealing with unpleasant or verbally/physically aggressive personalities Must be able to use electronic mail, telephone and texting Must be able to work in groups Must be able to perform structured and unstructured work Must be able to meet time pressure and time lines Includes possible exposure to human body fluids, disease, infection, lab chemicals and hazardous materials and/or cleaning solutions Requires wearing of common protective and safety equipment such as gloves, safety glasses, mask, gowns, etc. PHYSICAL FACTORS Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects.Must be able to tolerate prolonged periods of standing and walking Must be able to reach reasonable distances in any direction Must be able to stand, walk, kneel, bend, sit and stoop Must be able to run in an emergency Must have the ability to exert maximum muscle force to lift, push, pull and carry objects Must be able to move fingers in a coordinated manner and must be ablet o feel and perceive temperature, texture, shape and size with fingertips Must be able to perform the duties with or without reasonable accommodation Must possess stamina to work prolonged shifts Hearing and vision must be normal or corrected to within normal range. Physical presence onsite is essential.
Overview Plans, coordinates and directs quality, compassionate care by maintaining standards of professional nursing practice and creating positive therapeutic relationships with patients/families. Provides leadership to other team members by articulating and delegating expected standards of care, supervising and encouraging team members, and supporting their contributions. Supervises LPNs, PCAs, PCAs/US, US and/or Techs. KEY RESPONSIBILITIES / ESSENTIAL JOB FUNCTIONS Responsibilities Assesses condition on each assigned patient on admission and on an ongoing basis to include but not limited tothe patient’s physical condition, psychological status, social status, spiritual and cultural needs, pain assessment/management, nutritional and functional status, developmental or age related factors, and discharge planning needs. Specific ages: adolescent, adult and geriatric as defined by scope of service. Plans, provides and documents patient and/or significant other education based on physical, behavioral, psychological, developmental, and age-related factors, after identifying barriers to learning. Evaluates and regularly reevaluates the nursing needs of the patient; initiates, develops, implements, and makes necessary revisions to the patient’s plan of care according to problems identified. Assigns and delegates nursing care to team members in accordance with the patient’s needs and the capabilities of the team members. Applies safety principles when performing care and accurately documents observations, care provided and changes in care plan. Collaborates and coordinates with physicians and other disciplines regarding individualized patient treatment/care plans by participating in team conferences, care planning/problem identification and team shift reports. Assists in performance improvement (PI) activities by serving on PI teams as warranted, assisting with PI measures and supporting and implementing changes necessary for improvement. Accurately documents care provided/observations according to policies and procedures. Performs initial and annual competency per job class. DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Performs compliance requirements as outlined in the Employee Handbook Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self. Requires use of electronic mail, time and attendance software, learning management software and intranet. Must adhere to all DCH Health System policies and procedures. All other duties as assigned. MINIMUM KNOWLEDGE, SKILLS, EXPERIENCE MINIMUM KNOWLEDGE, SKILLS, EXPERIENCE Qualifications Current Alabama RN licensure. Must be able to read, write legibly, speak, and comprehend English. WORKING CONDITIONS WORK CONTEXT Job requires being careful about detail and thorough in completing work tasks. Includes exposure to human body fluids, disease, infection, lab chemicals and hazardous materials and/or cleaning solutions. Requires wearing common protective or safety equipment. Includes demonstrating leadership skills, delegating to team members, addressing conflict, communicating with all types of personalities, and being responsible for outcomes/results. PHYSICAL FACTORS Activities: Ability to tolerate prolonged periods of standing and/or walking. Ability to bend, stretch, twist, or reach with your body, arms, and/or legs. Must be able to do frequent stooping and on occasion, crouching, crawling or kneeling. Ability to reach reasonable distances in any direction. Ability to run in emergency situations. Must be able to move fingers in a coordinated manner. Must have ability to feel and perceive temperature, texture, shape and size with fingertips. Requirement: Medium work. Exerting up to 50 pounds of force occasionally, and/or up to 30 pounds of force frequently, and/or up to 10 pounds of force constantly to move objects. Able to push stretcher / wheelchair with average adult patient. Must be able to perform the duties with or without reasonable accommodation. Hearing and vision must be normal or corrected to within normal range. Physical presence onsite is essential. OTHER JOB FACTORS Job requires being open to change (positive or negative) and to considerable variety in the workplace. Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude. Job requires a willingness to take on responsibilities and challenges. Obtains baseline data while performing health assessments Utilize catheters and ports for blood sampling and medications as necessary. Set ambulatory infusional pumps, connect to vascular access device and teaches patient and family on all aspects of pump. Develop an individual approach for teaching patient and family regarding chemotherapy drugs, side effects, their management, route and interval to be given and the need for laboratory and x-ray studies. Assist as preceptor in clinical portion of chemotherapy certification. Demonstrates clinical expertise utilizing expanded knowledge, skills, and decision- making capability, and personalized nursing care to cancer patients. Screens for medical, physical, emotional and psychological problems related to cancer or its treatment with subsequent appropriate referrals. Assess and meet patient's needs by teaching, counseling, and coordinating all phases of care. Cross train to the Radiation Clinic. Demonstrates understanding of neutropenic precaution, radiation safety and infection control. Prior to administering new medication verifies that any necessary insurance prior authorization has been obtained. Certified and gives IV contrast media. Maintain BLS, Chemotherapy certification, OCN certification, and ONS chemotherapy & biotherapy certification as appropriate. Must adhere to AIDET principles. Know emergency procedures, tornado, fire disaster and code silver, etc.
Overview Plans, coordinates and directs quality, compassionate care by maintaining standards of professional nursing practice and creating positive therapeutic relationships with patients/families. Provides leadership to other team members by articulating and delegating expected standards of care, supervising and encouraging team members, and supporting their contributions. Supervises LPNs, PCAs, PCAs/US, US, ED Tech, ED Clerical/PCA, CRSS and OTs. Responsibilities Assesses condition on each assigned patient on admission and on an ongoing basis to include but not limited to the patient’s physical condition, psychological status, social status, spiritual and cultural needs, pain assessment/management, nutritional and functional status, developmental or age related factors, and discharge planning needs. Plans, provides, and documents patient and/or significant other education based on physical, behavioral, psychological, developmental, and age-related factors, after identifying barriers to learning. Evaluates and regularly reevaluates patient care; coordinates care planning with patient, family, providers and other disciplines to achieve patient-centered outcomes. Assigns and delegates nursing care to team members in accordance with the patient’s needs and the capabilities of the team members. Applies safety principles when performing care and accurately documents observations, care provided and changes in care plan. Participates in transition rounds, care planning/problem identification and team shift reports. Assists in performance improvement (PI) activities by serving on PI teams as warranted, assisting with PI measures and supporting and implementing changes necessary for improvement. Performs initial and annual competency per job class. DCH Standards: Maintains performance, patient and employee satisfaction and financial standards as outlined in the performance evaluation. Performs compliance requirements as outlined in the Employee Handbook Must adhere to the DCH Behavioral Standards including creating positive relationships with patients/families, coworkers, colleagues and with self. Requires use of electronic mail, time and attendance software, learning management software and intranet. Must adhere to all DCH Health System policies and procedures. All other duties as assigned. Qualifications Current Alabama RN licensure. Associate degree in Nursing required. Current American Heart Association (AHA) Basic Life Support (BLS) Provider training required. Professional Nursing Certifcation preferred. Must be able to read, write legibly, speak, and comprehend English. WORK CONTEXT Demonstrate leadership skills Requires decision making that will affect others Responsible to achieve outcomes Must be able to communicate clearly and accurately Ability to delegate to team members and students Must be able to receive delegation Address conflict and stressful situation Communicate with different personalities and engage in face to face discussion Dealing with unpleasant or verbally/physically aggressive personalities Must be able to use electronic mail, telephone and texting Must be able to work in groups Must be able to perform structured and unstructured work Must be meet time pressure and time lines Includes possible exposure to human body fluids, disease, infection, lab chemicals and hazardous materials and/or cleaning solutions Requires wearing of common protective and safety equipment such as gloves, safety glasses, mask, gowns, etc. PHYSICAL FACTORS Heavy work. Exerting up to 100 pounds of force occasionally, and/or up to 50 pounds of force frequently, and/or up to 20 pounds of force constantly to move objects Must be able to tolerate prolonged periods of standing and walking Must be able to reach reasonable distances in any direction Must be able to stand, walk, kneel, bend, sit and stoop Must be able to run in an emergency Must have the ability to exert maximum muscle force to lift, push, pull and carry objects Must be able to move fingers in a coordinated manner and must be ablet o feel and perceive temperature, texture, shape and size with fingertips Must be able to perform the duties with or without reasonable accommodation Must possess stamina to work prolonged shifts Hearing and vision must be normal or corrected to within normal range. Physical presence onsite is essential.
