RN Clinical Admissions Coord (Registered Nurse) - Per-Diem, M & F (8hr)
MemorialCare Saddleback Medical Center
May 21, 2018
Laguna Hills, California
Part Time - Experienced
Hospital, Public and Private
MemorialCare – Saddleback Medical Centers of excellence are renowned for prevention, diagnosis and treatment of cancer, heart disease, stroke, pulmonary disease, orthopedics and diabetes; and for leadership in emergency medicine, critical care medicine, breast health, outpatient rehabilitation, advanced imaging, women’s health, geriatric care and surgery, including robotic-assisted procedures.
Saddleback Medical Center (Orange County, CA) has consistently been named one of Healthgrades’ America’s 50 Best Hospitals, an achievement gained by just 1% of the nation’s hospitals. It has also been honored among Truven Health Analytics’ Top 50 Cardiovascular Hospitals in the U.S., consecutively voted Orange County’s Best Hospital in the Orange County Register’s Best of Orange County poll of readers and has appeared on both Becker’s Hospital Review and Thomson Reuters’ lists of America’s Best Hospitals. Saddleback’s U.S. News & World Report “high-performance” ranking categories included Heart Failure, Hip Replacement, Knee Replacement and Chronic Obstructive Pulmonary Disease.
The clinical admissions nurse screens all potential inpatient and outpatient admissions to the hospital to ensure admission criteria and requirements are met for appropriate level of care. This includes facilitating continuity of care, review of payor source benefits and authorizations, and patient education for anticipated hospitalization. In addition, this position is responsible to track statistical information and intervene as indicated to ensure timely billing and reimbursement. The clinical admissions nurse serves as a resource to physicians and hospital staff.
3 years acute care hospital experience
2-3 years in utilization management, case management, or registration services required.
Knowledge of current utilization management principles and criteria, third party payor guidelines, managed care models, reimbursement structures and the appeals process.
Knowledge of various agencies and regulations pertaining to Milliman Care Guidelines (MCG), JCAHO, Medicare, Medi-cal, etc.
Computer experience with word processing/spreadsheet programs, including MS Office and Windows XP is preferred.
CA RN License BSN required (within 36 months of hire)