RN Utilization Management Referral Coordinator HDVCH Med Psych

Pediatric Med Psych Hospital Coordinator

Schedule: Monday-Thursday 8:00 a.m. to 5:30 p.m. Every other Sat/Sun 8:00 a.m. to 12:00 p.m. (remote)

About Helen DeVos Children's Hospital

We fight for every child. With 350+ pediatric specialists and subspecialists, 12 years of U.S. News & World Report national rankings and innovations that draw patients from all over the world, we're driven to replace fear with hope and doubt with answers. We believe in the possibility of every child's future. Because it's only impossible until it isn't. We have both inpatient and ambulatory spaces as well as a Level 1 trauma Emergency Department designated to children.

Scope of Work

Supporting the essential referral, admission and insurance coordination functions for the first Pediatric Med Psych hospital in the state of Michigan. Manage all components of referral management, admission waiting list, insurance prior authorizations, continuous stay reviews and appeals. Additional support to the UM functions of the Corewell Health South Behavioral Health Inpatient unit.

• Assess internal and external referrals to identify patient/significant others' needs, level of intensity, insurance benefits and other patient resources.
• Develops plan of care and makes recommendations to PCPs, specialists and other members of the health care team regarding care management strategies, identifying strategies to maximize continuity of care across the continuum.
• Assess the educational needs of patients, families and members of the health care team and develops and implements appropriate teaching strategies or makes appropriate referrals.
• Communicates and collaborates with patient/significant others/providers/payers to coordinate services that improve access to appropriate services across the continuum of care and which promotes optimal health in a cost-effective manner.
• Measures patient care outcomes, interprets reports and analyzes data trends for groups of patients.
• Documents patient data, plan, interventions and outcomes according to department guidelines.

Qualifications

Required Bachelor's Degree or equivalent nursing or a healthcare related field (all departments except Spectrum Health Ludington) BSN must be obtained within 7 years for those who start in this RN role on or after January 1, 2017 (Spectrum Health Ludington Hospital) Required.

2 years of relevant experience clinical nursing and or case management/managed care or related field Required

5 years of relevant experience clinical nursing and or case management/managed care or related field Preferred

Registered Nurse (RN) - State of Michigan Upon Hire required

Basic Life Support (BLS) - AHA American Heart Association Ambulatory Care Management Upon Hire required Or

Basic Life Support (BLS) - ARC American Red Cross Ambulatory Care Management Upon Hire required

Case Manager, Certified (CCM) - CCMC Commission for Case Manager Certification Upon Hire preferred

How Corewell Health Cares for You

Comprehensive benefits package to meet your financial, health, and work/life balance goals.

On-demand pay program powered by Payactiv

Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

Optional identity theft protection, home and auto insurance, pet insurance

Traditional and Roth retirement options with service contribution and match savings

Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Helen DeVos Childrens Hospital - 100 Michigan St - Grand Rapids

Department Name Care Management - HDVCH

Employment Type Full time

Shift Day (United States of America)

Weekly Scheduled Hours 40

Hours of Work 8:00 a.m. to 4:30 p.m.

Weekend 8:00 a.m. to 12:00 p.m.

Days Worked Monday to Thursday then Every other Saturday and Sunday

Weekend Frequency Every other weekend

CURRENT COREWELL HEALTH TEAM MEMBERS Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category.

Corewell Health is committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.