RN Patient Transfer Center

I. POSITION SUMMARY

Responsible for assisting patient-care providers in accessing HCA's Emergency Departments and in-patient facilities, for urgent patient evaluation and/or admission and facilitate the patient transfer process, providing 24-hour services, 7 days per week.

Expedites consultation between referring patient-care providers and receiving physicians. Facilitates all communications with providers, staff and transporting agencies.

Applies InterQual Criteria and refers cases to the external Physician Advisor. Facilitates continuity of the interdisciplinary plan of care by providing Utilization services, as needed, and will promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization

Acts as a customer-service representative, taking appropriate steps to meet the needs of the callers as well as improve relations with referring providers, interacting with multiple departments and agencies, in order to ensure quality care to patients. Assists with patient triage, interacting with other call center staff. Performs other duties as assigned, consistent with the goals and scope of the department.

II. POSITION REQUIREMENTS

A. Licensure/Certification/Registration:

Current RN license to practice in the state of Utah. BSN preferred.

B. Education:

Graduate from accredited school of Nursing. Must maintain BLS certification.

C. Experience:

D. Shift Times:

Minimum of 5 years RN experience required, with increasing supervisory responsibilities. Previous experience in ED/ Critical Care, Charge Nurse/ House Supervisor, Educator and Case Management helpful. Must be familiar with basic hospital transfer and admission process. Call Center/ Transfer Center experience preferred.

12-hour shifts, rotating weekdays/ weekends, days/ nights, as needed for coverage.

Possible on-call shifts, weekends, nights.

III. DEGREE OF SUPERVISION REQUIRED

Employee is expected to perform most duties independently and in accordance with established policies and procedures. The supervisor of this position will provide support and general guidance.

I. FUNCTIONAL REQUIREMENTS

Must be able to tolerate long periods of sitting. Must be able to speak clearly ad communicate in professional manner. Frequent need for hearing acuity, eye/hand/finger dexterity/ coordination. Requires corrected hearing and vision (including color) to within functional ranges. Must be able to multi-task and handle medium level of stress. Must be able to lift and carry 15--25 pounds, reach and stretch above and below shoulder level. Some pushing/pulling/kneeling/bending required.

II. MAJOR ROLE RESPONSIBILITIES

* Manages all inbound and outbound calls supported by the Transfer Center, identify patient needs and takes appropriate action according to established department policies/ procedures., including but not limited to requests for physician consultation and patient transfer.

* Facilitates communication between patient-care providers and all necessary staff at referring and receiving facilities.

* Communicates with multiple departments and agencies in order to ensure quality care to patients, including but not limited to communications related to facility capabilities, bed availability and assignment, urgent patient-care needs, patient transportation, report to receiving unit, insurance pre-authorization for transfer/admission, providing feedback to multiple customers, obtaining clinic appointments for patients, ensuring transfer of documents and medical records between facilities

* Collaborates with physicians, Patient Access Coordinators, Case Managers, Administrators, Bed Manager and Hospital Supervisors to prioritize patient needs and facilitate transfer.

* Facilitates insurance pre-authorization, as defined by department policies/ procedures.

* Maintains accurate and timely documentation, relating to all calls; assists in maintaining database.

* Follows up with referring and receiving providers, to gather feedback and ensure a seamless process.

* Promotes customer service attitude and builds working relationships with internal and external customers.

* Supervises, educates and supports non-licensed staff. Acts as a resource in decision-making process.

* Assists with quality assurance, process improvement and other department projects necessary to department's function.

* Actively participates in outreach and marketing, developing and presenting educational materials and visiting other facilities.

* Escalates issues and communicates appropriately with Director, as appropriate.

* Escalates concerns and communicates with hospital administrator on-call, as outlined in department policies/ procedures.

* Evaluates new admissions for medical necessity using approved criteria through the utilization of the electronic T system, application of the criteria for medical necessity determination and appropriateness of level of care.

* Performs review for medical necessity applying InterQual criteria, documents review in Midas and sends the Physician Advisor referral through Midas per protocol.

* Consults with ED Physicians/Admitting physicians and facility Physician Advisors on patient admission status;

III. METHODS AND TECHNIQUES: While not exclusive, the following list is meant to describe general work practices

* Prioritizes incoming calls, based on patient needs and collaboration with patient-care providers.

* Promotes and maintains system security, patient confidentiality and business confidentiality.

* Adheres to HCA and department policies and complies with Code of Conduct

* Actively participates in department meetings and contributes positively to work environment.

* Welcomes feedback and strives to meet or exceed standards.

* Maintains flexibility in planning for patient needs and updates arrangements, as needed.

* Supports the vision and goals of HCA and the department and positively promotes the services.

* Builds and maintains professional relations between department staff and all customers.

* Assists with selection, training and retention of staff.

* Takes initiative and seeks opportunities for self-improvement and continuing education.

* Will evaluate admission status, medical necessity and level of care assignments, with a primary focus of patients admitted through the Emergency Department utilizing the electronic T-System and those admitted throughout the day, using Midas.

* Proficient use of electronic T--System, use of Midas and other office-oriented systems as needed

* Provides excellent customer relationship skills with the observance of telephone and electronic mail ethics.

* Sends appropriate cases to physician advisors for further evaluation of medical necessity.

* Tracks and trends variances and barriers to care; makes recommendations and develops action plans to improve processes and systems

SPECIAL QUALIFICATIONS

* Familiar with computer use; must be able to learn new processes quickly and educate others.

* Demonstrates proficiency with hardware and software, required to perform tasks.

* Demonstrates knowledge of internal and external customers and understands service standards.

* Must complete all Healthstream training modules, within 1 month of hire and maintain annual training requirements.

* Knowledge of the Case Management process and the Utilization Review Process

* Knowledge of InterQual Criteria

* Knowledge of Medicare regulations as they relate to Inpatient, Observation, Outpatient Services and Condition Code 44