Summary Recommends the most efficient, cost effective utilization of resources within the continuum of care, prior to the delivery of services. Evaluates, assesses, plans and facilitates a plan of care. Precertifies inpatient and outpatient services. Some overtime and call back is required. This position is under the general direction of the Director for Medical Review Services/Case Management. Performs other duties as assigned.Responsibilities
Assesses and evaluates clinical and financial information available and recommends the most appropriate setting for service delivery, including level of care in order to optimize resource consumption and reimbursement.
Precertifies patient care services that require precertification, as identified, in a timely, efficient manner, in order to optimize reimbursement for the patient, as well as health care providers.
Communicates recommendations, clinical information, and fiscal information to appropriate internal and external customers in order to facilitate optimal delivery of services and customer satisfaction.
Participates in the planning, data collection, and analysis phases of performance improvement activities in order to maximize the patient placement/precertification process.
Completes assigned goals.
Requirements, Preferences and Experience ExperiencePreferred: Prefer additional two years of quality/utilization management or dischage planning experience.Minimum: LPN with three (3) years of acute care experience; or an individual with 5 years of utilization management/case management experience.Licensure, Registration, CertificationPreferred: LPNSpecial SkillsMinimum: Excellent communication skills. Advanced computer literacy skills.About Baptist Memorial Health Care At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.At Baptist, We Offer:
Competitive salaries
Paid vacation/time off
Continuing education opportunities
Generous retirement plan
Health insurance, including dental and vision
Sick leave
Service awards
Free parking
Short-term disability
Life insurance
Health care and dependent care spending accounts
Education assistance/continuing education
Employee referral program
Job Summary: Position: 5047 - Specialist-Patient Placement LPNFacility: BMH - North Mississippi Oxford HospitalDepartment: NM Scheduling BMH North MSCategory: Nurse LPNType: Non ClinicalWork Type: PRNWork Schedule: DaysLocation: US:MS:OxfordLocated in the Oxford, MS metro area REQNUMBER: 24795
