Northwestern Memorial Healthcare Clinical Admission Nurse - Utilization Review McHenry, Full-time, Days in McHenry, Illinois
The *Clinical Admission Nurse* reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. *Responsibilities:* * Serves as an access point resource for physicians, staff, and patients. * Assists with the most appropriate level of care and admission status. * Applies approved criteria and guidelines in decision making, as well as managed care rules and practices. * Ensures a smooth admission experience for patients by coordinating clinical needs with operational processes and insurance benefits. * Ensures the patient is at the most appropriate level of care for the expressed severity of illness and level of services required. * Applies national guidelines and provides clear communication with physicians. * Assists in easy access to incoming patients by arranging transportation when necessary, coordinating services, and notifying points of entry of patient's impending arrival. * Queries the admitting physician for additional information as needed to meet medical necessity for admission or appropriate level of care. * Refers cases to physician advisor for any outlier cases. * Coordinates admission with registration staff to obtain accurate patient demographics as indicated. * Refers appropriate cases to patient financial services, risk, peer review, infection control and patient relations. * Knowledgeable of the available outpatient resources and sites of care within the organization for referral to lesser levels of care when appropriate. * Coordinates patient activity and flow or movement between levels of care. * Identifies potential throughput barriers and acts proactively to inform and alert upper management of anticipated delays. * Reviews clinical against MCG criteria to help determine patient class and level of care needed. * Confers with MD to discuss clinical and appropriate level of care when needed. * Performs other duties as assigned *Required:* * BSN * AHA BLS certified * At least two to five years of patient care experience in a hospital setting. * Able to multi task quickly, and process multi-factoral stimulation accurately. * Requires critical thinking skills, decisive judgment, and the ability to work with minimum supervision *Preferred:* * Past experience in admissions, bed placement, utilization review activities, discharge planning, and/or case management. * Ability to collaborate with others, strong intrapersonal skills Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.