Clinical Evaluator - RN Hospital
Company: KPC Promise Healthcare LLC
Location: Baton Rouge
Posted on: January 24, 2023
Job Description:
KPC Promise Hospital of BATON ROUGE : The Clinical Evaluator is
responsible for collecting and evaluating clinical information and
assists in the determination of appropriateness for admission to
the facility based on independent discretion and knowledge of
InterQual criteria. In addition, he/she evaluates and communicates
special needs, potentially high-risk cases, physician and/or
insurance objectives, and patient/family dynamics and expectations
to the Director of Case Management and Nursing Management.
QUALIFICATIONS:
- Current state license as either a Registered Nurse, Licensed
Practical Nurse, Respiratory Therapist or Physical Therapist
- Two or more years of hospital clinical experience, preferably
in an acute care setting
- Ability to collect clinical information and apply criteria for
potential admission including estimated length of stay,
patient/family expectations, and discharge plans
- Strong medical assessment skills
- Experience in commercial insurance, Medicare and Medicaid
reimbursements is preferred
- Experience in in-service education and public speaking
- Experience in Utilization Review and/or Case Management
- Understanding of InterQual and LTACH criteria for admissions
and continued stays
- Must have a valid drivers license and a clean motor vehicle
record, as well as carry applicable insurance as required by state
law
- Must be able to read, write, and speak English, Bilingual
desired PHYSICAL AND MENTAL REQUIREMENTS: Physical: Walking - up to
75% Standing - up to 25% Kneeling - up to 15% Sitting - up to 50%
Pushing - up to 15% Bending - up to 10% Squatting - up to 10%
Pulling - up to 15% Reaching - up to 15% Lifting - up to 50lbs
Wrist/Finger Movements - up to 90% Mental: Stress Level: Moderate
to High EXPOSURE RISK:Category II - Jobs in which required tasks
normally do not involve exposure to blood, body fluids or tissues
but which could result in Category I exposure. EQUIPMENT, TOOLS,
MATERIALS, MACHINES USED: Pager, cell phone, copier, fax, basic
computer skills, understanding of electronic charting, wireless
communication CERTIFICATIONS:RN, LVN/LPN, PT, RT #ZR
PI201868455
Keywords: KPC Promise Healthcare LLC, Baton Rouge , Clinical Evaluator - RN Hospital, Other , Baton Rouge, Louisiana
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