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Clinical Operations Specialist (RN Case Management)

Job Description



Overview

Envision Physician Services is a multispecialty physician group and practice management company. Established in 1953, our organization provides anesthesia, emergency medicine, hospital medicine, radiology, primary/urgent care, surgical services, and women’s and children’s health services to hospitals and health systems nationwide. Sheridan Healthcare, EmCare, Reimbursement Technologies and Emergency Medical Associates have recently joined forces to form Envision Physician Services.  As one organization, we now provide a greater scope of service than any other national physician group. Our collective experience from hundreds of local, customized engagements, culture of continuous lean process improvement, and team of experts in the business of healthcare enable us to better solve complex problems and consistently give healthcare organizations confidence in our execution. Our combined organization serves more than 780 healthcare facilities in 48 states and the District of Columbia. 


If you are looking for a stable, fast-paced, growing company in the healthcare industry that is committed to innovation, excellence and integrity, then this may be a great next step in the advancement of your career.


We currently have an exciting opportunity available for an experienced Clinical Operations Specialist.



Responsibilities

POSITION SUMMARY

The Clinical Operations Specialist utilizes clinical experience to collaborate with the hospitalist care team to coordinate and manage the process of patient care within the hospitalist program. This role supports and leads hospital-based operational workflows for the Bundled Payment for Care Improvement Advanced (BPCI-A) program. The Clinical Operations Specialist is key to crucial components of BPCI-A program operations, including patient identification, discharge planning, and care coordination post-discharge.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Establish and maintain strong relations with Medical Director, Nursing Managers, providers, nursing staff, hospital administration and Envision personnel to support shared goals and initiatives. Supports and takes direction from the local Director of Client Services.
  • Actively participates in daily standup meeting with Hospitalist’s to ensure communication and implementation of patient plan of care. Acts as a conduit for identifying and communicating issues and plans to Hospitalist staff.
  • Using medical background/knowledge, communicates patient issues/concerns to Hospitalist when presented by the hospital, patient’s families, or the patients. Supports hospitalist and the hospital care team in obtaining medical information from patient’s primary care provider and the timely implementation of patient care plans, especially at transition points along the continuum of care.
  • Identify and verify BPCI-A patients and post-acute discharge location through use of care management software, charge capture system, and hospital electronic medical record.
  • Address data integrity issues related to patient eligibility, diagnosis information, and next site of care disposition.
  • Complete patient assessment to help identify post-acute care and readmission risk
  • Potential use of decision support tool to help in guidance for discharge planning in addition to collaboration with attending physician on tool’s recommendations.
  • Collaborate with hospital case management department on patient’s discharge process, including assessment and coordination of post-discharge needs and including the development of care plans.
  • Distribute key clinical information between acute and post-acute providers
  • Collaborate with post-acute liaisons on transitions to skilled nursing facility and possible readmissions back to your assigned hospital/hospitals.
  • Possible follow-up with the patients via care coordination phone calls through 90 days post-discharge.
  • Other duties as assigned
  • Reads and abides by the company’s code of conduct, ethics statements, employee handbook(s), policies and procedures and other corporate mandates, including participation in mandatory training programs
  • Reports any real or suspected violation of the corporate compliance program, company policies and procedures, harassment or other prohibited activities in accordance with the reporting policies of the company
  • Obtains clarification of policy whenever necessary and may use the resources available through the Compliance, Human Resources or Legal Department to do so


Qualifications

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

  • Knowledge of hospital operations, discharge planning, and specific role of the case management, physical therapy, and hospital medicine departments
  • Knowledge of care coordination alignment in value based care program preferred
  • Excellent communication and organizational skills with attention to detail
  • Familiarity with electronic medical records and billing systems
  • Strong interpersonal skills
  • Good judgment and understanding of HIPAA laws to maintain patient confidentiality
  • Driver’s license as onsite presence and possible travel across different hospitals will be required

Education/Experience:

  • BSN degree or RN license preferred
  • Minimum of 3-5 years healthcare experience with at least 1-2 years experience with case management or post-acute experience

Computer Skills:

  • To perform this job successfully, an individual should have knowledge of:
    • Microsoft Office Suite
    • Knowledge of case management tools preferred

Certificates and Licenses:

  • RN license preferred

If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts! We offer a competitive salary and a comprehensive benefits package.


Envision Physician Services uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify.

 

Envision Physician Services is an Equal Opportunity Employer.


#LI-TY1

Job Requirements

 

Job Snapshot

Location US-TN-Dyersburg
Employment Type Full-Time
Pay Type Year
Pay Rate N/A
Store Type Health Care
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Company Overview

Envision Healthcare

Envision Healthcare was founded decades ago under a different name – Emergency Medical Services Corporation – with a vision to focus on 24/7 emergent care, both in the hospital and in the field. As time passed, the population and the healthcare industry changed and the company kept pace. The company’s vision expanded to deliver services across the entire care continuum. Today no other company offers the depth and breadth of services provided by Envision Healthcare … hospital-based physician services (EmCare), emergent and non-emergent medical transportation (AMR) and population health management provided where and when patients need it by healthcare professionals whose skills match patient needs (Evolution Health). Over the years we have adapted our services as the population has aged, as legislation has changed, as new technologies have been introduced. Learn More

Contact Information

US-TN-Dyersburg
Snapshot
Envision Healthcare
Company:
US-TN-Dyersburg
Location:
Full-Time
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Health Care
Store Type:

Job Description



Overview

Envision Physician Services is a multispecialty physician group and practice management company. Established in 1953, our organization provides anesthesia, emergency medicine, hospital medicine, radiology, primary/urgent care, surgical services, and women’s and children’s health services to hospitals and health systems nationwide. Sheridan Healthcare, EmCare, Reimbursement Technologies and Emergency Medical Associates have recently joined forces to form Envision Physician Services.  As one organization, we now provide a greater scope of service than any other national physician group. Our collective experience from hundreds of local, customized engagements, culture of continuous lean process improvement, and team of experts in the business of healthcare enable us to better solve complex problems and consistently give healthcare organizations confidence in our execution. Our combined organization serves more than 780 healthcare facilities in 48 states and the District of Columbia. 


If you are looking for a stable, fast-paced, growing company in the healthcare industry that is committed to innovation, excellence and integrity, then this may be a great next step in the advancement of your career.


We currently have an exciting opportunity available for an experienced Clinical Operations Specialist.



Responsibilities

POSITION SUMMARY

The Clinical Operations Specialist utilizes clinical experience to collaborate with the hospitalist care team to coordinate and manage the process of patient care within the hospitalist program. This role supports and leads hospital-based operational workflows for the Bundled Payment for Care Improvement Advanced (BPCI-A) program. The Clinical Operations Specialist is key to crucial components of BPCI-A program operations, including patient identification, discharge planning, and care coordination post-discharge.

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Establish and maintain strong relations with Medical Director, Nursing Managers, providers, nursing staff, hospital administration and Envision personnel to support shared goals and initiatives. Supports and takes direction from the local Director of Client Services.
  • Actively participates in daily standup meeting with Hospitalist’s to ensure communication and implementation of patient plan of care. Acts as a conduit for identifying and communicating issues and plans to Hospitalist staff.
  • Using medical background/knowledge, communicates patient issues/concerns to Hospitalist when presented by the hospital, patient’s families, or the patients. Supports hospitalist and the hospital care team in obtaining medical information from patient’s primary care provider and the timely implementation of patient care plans, especially at transition points along the continuum of care.
  • Identify and verify BPCI-A patients and post-acute discharge location through use of care management software, charge capture system, and hospital electronic medical record.
  • Address data integrity issues related to patient eligibility, diagnosis information, and next site of care disposition.
  • Complete patient assessment to help identify post-acute care and readmission risk
  • Potential use of decision support tool to help in guidance for discharge planning in addition to collaboration with attending physician on tool’s recommendations.
  • Collaborate with hospital case management department on patient’s discharge process, including assessment and coordination of post-discharge needs and including the development of care plans.
  • Distribute key clinical information between acute and post-acute providers
  • Collaborate with post-acute liaisons on transitions to skilled nursing facility and possible readmissions back to your assigned hospital/hospitals.
  • Possible follow-up with the patients via care coordination phone calls through 90 days post-discharge.
  • Other duties as assigned
  • Reads and abides by the company’s code of conduct, ethics statements, employee handbook(s), policies and procedures and other corporate mandates, including participation in mandatory training programs
  • Reports any real or suspected violation of the corporate compliance program, company policies and procedures, harassment or other prohibited activities in accordance with the reporting policies of the company
  • Obtains clarification of policy whenever necessary and may use the resources available through the Compliance, Human Resources or Legal Department to do so


Qualifications

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

  • Knowledge of hospital operations, discharge planning, and specific role of the case management, physical therapy, and hospital medicine departments
  • Knowledge of care coordination alignment in value based care program preferred
  • Excellent communication and organizational skills with attention to detail
  • Familiarity with electronic medical records and billing systems
  • Strong interpersonal skills
  • Good judgment and understanding of HIPAA laws to maintain patient confidentiality
  • Driver’s license as onsite presence and possible travel across different hospitals will be required

Education/Experience:

  • BSN degree or RN license preferred
  • Minimum of 3-5 years healthcare experience with at least 1-2 years experience with case management or post-acute experience

Computer Skills:

  • To perform this job successfully, an individual should have knowledge of:
    • Microsoft Office Suite
    • Knowledge of case management tools preferred

Certificates and Licenses:

  • RN license preferred

If you are ready to join an exciting, progressive company and have a strong work ethic, join our team of experts! We offer a competitive salary and a comprehensive benefits package.


Envision Physician Services uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify.

 

Envision Physician Services is an Equal Opportunity Employer.


#LI-TY1

Job Requirements

 
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