The RN Clinical Coordinator is responsible for the day to day coordination of admission criteria as it relates to healthcare needs of the patient and organization. Including knowledge of regulatory and compliance with Medicaid and other insurance payors. This team member will communicate with a variety of clinical disciplines, commercial payers, patient access, patient financial services, physician advisor and other staff members.

Required Education:

Graduate of an accredited

Nursing Program Preferred Education:

Bachelors of Science Degree in Nursing (BSN)

Required Experience:

Three (3) years of experience in acute care nursing. Computers skills a must as well as excellent communication and the ability to work collaboratively with other disciplines

Required Certifications and Licensures:

Hold a current, active license as a registered nurse in Virginia or hold a current multistate/compact license. Hold a current, active American Heart Association Basic Life Support (AHA BLS) course completion card.

Preferred Certifications and Licensures:

ACMA Certification Responsibilities Provides, initial, concurrent and retrospective reviews if assigned patients for severity of illness and intensity of service Works with Director and other staff members to establish a climate of trust and collaboration Provides accurate and complete account authorization and details in plan notes Performs admission review within 24 hours of patient's admission Involves the Physician Advisor as needed when physician-to-physician interaction is required to achieve appropriate clinical utilization for the patient Collaboratively works with the Physician Advisor to facilitate all aspects of the utilization management plan Serve as a liaison to patient accounting, patients access as it relates to authorizations and claims Demonstrates ability to communicate effectively with internal and external customers Demonstrates commitment toward customer satisfaction and patient advocacy Maintains confidentiality of patient/physician/and other team members as well as maintaining compliance with all federal/state guidelines and regulations Achieves budget length of stay (LOS) goal Assesses patients' needs develops and implements nursing care plans and evaluates effects of nursing care With Manager and Medical Director provides leadership in developing outcome based patient care improvements May perform other duties as assigned or requested and job specifications can be modified or updated at any time