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Care Facilitator- Per Diem- Canton-Potsdam Hospital

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Job Title: Care Facilitator

Department: Case Management

Location: Canton-Potsdam Hospital with floating to other hospital locations

Hours Per Week: Per Diem

Schedule: 8-hour variable shifts, occasional weekends

SUMMARY: Comprehensively plans with the health care team to ensure patient needs are met and care delivery is coordinated across the continuum. Identifies and works to eliminate/minimize system variation and service delivery barriers that prevent achievement of optimal patient outcomes in the expected time frame and with most efficient utilization of resources. Carries out activities related to utilization management, discharge planning, care coordination and referral to other levels of care. Performs as an integral part of the interdisciplinary team promoting interdisciplinary collaboration and champions service excellence. Facilitates assignment of level of care, considers payer requirements and responds accordingly to avoid adverse financial consequence to patient and hospital. Provide superior customer service by modeling the Brand Promise and Core Values.

RESPONSIBILITIES:

Conducts clinical reviews utilizing objective criteria (Interqual) to assign patient to the appropriate level of care; identifies clinical resources required to achieve optimal patient outcomes and appropriate reimbursement for the hospital.
Documents level of care and medical necessity in the Care Management Data base to support the clinical review process.
Concurrently monitors resources utilization, performing continued stay reviews and assists with managing the length of stay of patients across the continuum.
Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based on medical necessity to support timely progress of patient along the continuum.
Functions as a resource to health care team for payor requirements, ensuring optimal use of patient health care benefits.
Fosters relationships with payors and facilitates communication between hospital and payor as appropriate.
Concurrently communicates clinical information to payors; severity of illness, intensity of service and plan of care.
Performs retrospective reviews on insurance denials and assists in appeal process.
Participates in daily Huddles, providing ongoing communication to the Charge Nurse and Nurse Manager to address complex clinical issues, system barriers, and patient/family issues, concerns.
Works with Care Management Leadership to identify problems, recommend solutions and work toward resolution.
Utilizes data, trends and reports to proactively identify opportunities to improve processes and practice.

REQUIRED QUALIFICATIONS:
Required Degree

Associates degree from an accredited School of Nursing required

Required Certification/Licensure

Licensed in New York State as a Registered Nurse

Required Years of Experience

For hires after 10/28/2024, 3 years acute hospital care experience required. If, hired prior to 10/28/2024, 3 years acute hospital care experience not required.

PREFERRED QUALIFICATIONS:

Case Management or Utilization Management experience preferred.
Bachelor’s Degree preferred

EDUCATION:

LICENSES / CERTIFICATIONS:

BLS - Basic Life Support - American Heart Association (AHA), RN - Registered Nurse - New York State Education Department (NYSED)

PHYSICAL REQUIREMENTS:

M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$33.50 - $43.50

CITY:

Potsdam

POSTAL CODE:

13676

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity/Affirmative Action Employer.
Minority/Female/Disability/Veterans by a prospective employee and/or employee’s Physician or delegate will be considered for accommodations.

Average salary estimate

$39460 / YEARLY (est.)

min

max

$33560K

$45360K

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What You Should Know About Care Facilitator- Per Diem- Canton-Potsdam Hospital, RRHS

As a Care Facilitator for Canton-Potsdam Hospital, you're stepping into a pivotal role designed to enhance patient outcomes and improve care coordination. This position is your gateway to collaborate with an interdisciplinary team, ensuring patients receive excellent medical attention throughout their healthcare journey. Whether you're engaging in utilization management or discharge planning, your expertise will play a key role in assessing and managing patients' levels of care. The flexible per diem schedule means you can work variable shifts, including weekends, providing you with the opportunity to balance your professional and personal life while making a meaningful impact every day. In your day-to-day activities, you will utilize clinical criteria to assign the right level of care, monitor resource utilization, and communicate effectively with payors. By fostering relationships and ensuring appropriate services, you’ll be the linchpin that connects patients, families, and healthcare providers. If you have an Associate’s degree in nursing and a valid New York State RN license, you're already on the right track. Bring your three years of acute hospital experience (or the willingness to grow) for this role and help shape processes that can lead to exceptional patient journeys at Canton-Potsdam Hospital. Join our team and exemplify the values we hold dear while serving our community with compassion and excellence!

Frequently Asked Questions (FAQs) for Care Facilitator- Per Diem- Canton-Potsdam Hospital Role at RRHS

What are the primary responsibilities of a Care Facilitator at Canton-Potsdam Hospital?

The primary responsibilities of a Care Facilitator at Canton-Potsdam Hospital include planning patient care in collaboration with the healthcare team, managing utilization reviews, overseeing discharge planning, and facilitating communication between payors and the hospital. This role is vital in ensuring that patients receive timely and appropriate care while maximizing resource utilization.