Position Title: RN, Care Coordination- Utilization Review Department: Care Coordination # Purpose: Concurrently and retrospectively ensures the patient#s progress in the acute episode of care through post discharge and is quality driven while being efficient, cost effective, and safe discharge plan. Works with physicians to facilitate effective and efficient transitions 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, and that resources are efficiently and effectively utilized. Serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information. # Report To: Director, Care Coordination # Supervisory Responsibility: Guidance: The job requires the provision of occasional guidance and training to others. The job does not have formal or official supervisory responsibilities. # Materials Responsibility: Moderate: Work requires moderate responsibility for material resources. Examples of resources could include operating budgets for a work unit or department, specialized equipment, costly or unusual materials or supplies, large amounts of cash or other material assets. The employee has a moderate amount of control over these resources. The cost of errors might result in moderate damage, waste or financial loss. The difficulty, variety and depth of problems associated with these material resources is moderately complex. # Key Relationship: Co-workers/Health System Employees, Outside Agencies/Other Health Care Providers, Physicians/Medical Office Staff, Students/Interns/Residents/Outside Instructors, Third Party Payors/Insurance Companies, Auditors/Review Agencies # POSITION SPECIFICATION # Education: Bachelor#s Degree # Field Of Study: Nursing, or related field # Special Training: Basic Life Support # Training Preferred: Certification in Case Management, Professional Utilization Review or Managed Care; DRG/CPT knowledge; Interqual Admission/Continued Stay criteria knowledge # Licensure/Registration: Registered Nurse in Iowa or Illinois at time of hire, second state required within 1 year. # Experience: More than 3 years experience required. # Interpersonal Skills: Interaction is with a variety of people inside or outside the organization. Communications are of moderate difficulty and sensitivity. Contact with others may involve detailed # lengthy dialogues # exchanges of information. Requires a moderate amount of interpersonal skills. Interactions involve dealing with moderately complicated problem situations or stressful encounters. # Working Conditions: There are little or no adverse environmental conditions to consider. # Possible Exposure to Blood Borne Pathogens: Yes # Miscellaneous:

Position Title: RN, Care Coordination- Utilization Review

Department: Care Coordination

Purpose: Concurrently and retrospectively ensures the patient's progress in the acute episode of care through post discharge and is quality driven while being efficient, cost effective, and safe discharge plan. Works with physicians to facilitate effective and efficient transitions 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, and that resources are efficiently and effectively utilized. Serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information.

Report To: Director, Care Coordination

Supervisory Responsibility: Guidance: The job requires the provision of occasional guidance and training to others. The job does not have formal or official supervisory responsibilities.

Materials Responsibility: Moderate: Work requires moderate responsibility for material resources. Examples of resources could include operating budgets for a work unit or department, specialized equipment, costly or unusual materials or supplies, large amounts of cash or other material assets. The employee has a moderate amount of control over these resources. The cost of errors might result in moderate damage, waste or financial loss. The difficulty, variety and depth of problems associated with these material resources is moderately complex.

Key Relationship: Co-workers/Health System Employees, Outside Agencies/Other Health Care Providers, Physicians/Medical Office Staff, Students/Interns/Residents/Outside Instructors, Third Party Payors/Insurance Companies, Auditors/Review Agencies

POSITION SPECIFICATION

Education: Bachelor's Degree

Field Of Study: Nursing, or related field

Special Training: Basic Life Support

Training Preferred: Certification in Case Management, Professional Utilization Review or Managed Care; DRG/CPT knowledge; Interqual Admission/Continued Stay criteria knowledge

Licensure/Registration: Registered Nurse in Iowa or Illinois at time of hire, second state required within 1 year.

Experience: More than 3 years experience required.

Interpersonal Skills: Interaction is with a variety of people inside or outside the organization. Communications are of moderate difficulty and sensitivity. Contact with others may involve detailed & lengthy dialogues & exchanges of information. Requires a moderate amount of interpersonal skills. Interactions involve dealing with moderately complicated problem situations or stressful encounters.

Working Conditions: There are little or no adverse environmental conditions to consider.

Possible Exposure to Blood Borne Pathogens: Yes

Miscellaneous: