RN / Rehabilitation Nursing Job in Orange Park, Florida / Hospital
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Description
Standard Qualifications: Under general supervision of the AVP/RVP/DO, The Central Authorization Manager is responsible for managing and coordinating all day to day inpatient rehabilitation admissions with the Clinical Rehabilitation Specialists and/or admissions staff with all managed care payers by utilizing a holistic interdisciplinary approach to coordinate the insurance approval of care of all rehabilitation patients to assure smooth, efficient functioning rehabilitation units and delivery of quality health care services. He/she will lead a team of four RN Authorization Coordinators in an effort to achieve these goals. Additional duties and responsibilities: Acts as the clinical resource for the department. Utilizes other clinical specialists/coordinators as a resource for clinical growth, operations improvement, and for the coordination/participation in quality improvement activities and audits as necessary.Development of new programs and clinical procedures and collaboration with the Division Rehab Units to promote efficiency and customer service and assists Program Directors as necessary to promote effective daily operations. Assist AVP/RVP/DO with coordination and management of central authorization program.Supports Division Excellence standards and mission/vision of hospitals that are supported. Assumes additional supervisory/administrative responsibilities as assigned by RVP/AVP/DO. The majority of the responsibilities involve central insurance authorization for the Inpatient Rehab Service Line for the Divisions identified for the effective and efficient admissions process in the delivery of these services: Continuously evaluates, develops a plan and conducts business with insurance payers for the appropriate approval/authorization for inpatient rehabilitation pateints to meet the individual needs of medically referred patients in an efficient, productive manner and within the established guidelines for HCA and Nursing Professional Standards for Practice and Code of Ethics. To maintain accurate, current records on all patients according to policy and procedures. To assist with educational programs for departmental and hospital associates and to uphold the standards of the department and hospital by dealing with patients, visitors, associates and other medical professionals in a respectful, courteous manner. Additional Duties for Lead Coordinator/Supervisor: The Lead Coordinator/Spervisor assumes the responsibility for the coordination of the Rehab Central Authorization (RCA) staff and practices to assure an efficient admission process for all patients by receiving referrals from Division(s) served. Participates in strategic planning, program segmentation and development. Participates in performance improvement activities to assure continuous Quality Improvement/compiles those reports and shares data with respective leadersParticipates in the compiling of data, reviews and reports out to each Division the outcomes as related to Rehab Central Authorization processAnnually completes competencies and meets mutually agreed upon performance goals/objectives as listed on the Performance Management Plan. Performs and is responsible for evaluating staff competencies and performances goals/objectives annually. Manages the work schedule of the RCA office to assist in the management of budgeted FTE's /completes all necessary human resource functions related to the central authorization teamEnsures the appropriate allocation of hours/FTEs to the respective DivisionsEnsures ongoing communication between RCA/RVP/AVP/DO/and Division and Hospital leadership Ensures allocation of daily work flow to meet needs of the host facilities
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