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