Registered Nurse; RN), Care Command

Job Summary

Access Care Manager (CM) is responsible for managing entry and coordination of patients into the hospital. The CM addresses issues related to the planning, execution and management of bed placement for all admissions from all entry points into the hospital (e.g., Emergency Center, direct admits, transfers, etc.) in accordance with the clinical standards and guidelines set forth by Phoebe Putney Memorial Hospital.

The CM performs admission clinical reviews for appropriate level of care and patient status, and is responsible for ensuring that patients are admitted to the most appropriate bed available to meet their clinical needs using established criteria for admission. All patient transfer activities follow EMTALA regulations and guidelines.

• Associate Degree in Nursing required;
  Bachelor’s Degree in Nursing preferred.
• 3 years progressive clinical and basic management experience required.
• Registered Nurse (RN) with current Georgia license.

• Effective communication with care management, nursing, physicians, and other disciplines.
• Maintain patient confidentiality and follow applicable hospital and department policies.
• Demonstrate effective communication and team building skills.
• Think outside the box in decision‑making processes.
• Understand and fulfill job responsibilities and expectations, applying knowledge and skills to function proficiently as an Access CM.
• Serve as patient advocate in support of the hospital mission and goals.
• Maintain knowledge of federal, state and accreditation requirements applicable to utilization review; demonstrate compliance.
• Perform all parts of the job effectively and efficiently; requires minimal day‑to‑day direction.
• Serve as a resource and share best practices and answer questions as needed.
• Ensure consistent application of EMTALA regulations according to scope of role and decision‑making.
• Educate physicians and others about regulatory and payer issues that impact admission or transfer processes.

• Perform utilization review functions, document and record‑review activity, follow‑up and outcomes in the appropriate electronic system.
• Accurately document UM‑related reviews, referrals, and activities.
• Use correct terminology, conform to required style and format.
• Apply clinical criteria to reviews and payer standards.
• Review transfer or admission documents according to established criteria and standards; discuss level of care with the admitting physician or designee and refer medical‑necessity issues to the physician advisor.
• Seek guidance or escalates cases to the team lead or director for direction or administrative support.
• Notify admitting physician promptly and follow EMTALA regulations.
• Determine if authorization requirements impact patient or hospital liability and refer to appropriate area for action.

• Engage in teamwork as a team player and leader.
• Educate staff, physicians and patients about the role of Access Care Manager.
• Serve on committees or participate in projects, with opportunities for shared decision‑making and being a change agent.
• Promote professionalism of the care management role through participation in professional organizations.
• Incorporate evidence‑based knowledge into practice.

• Identify actions and strategies that positively impact care coordination, efficiency and effectiveness.
• Use creativity and innovation to improve Access CM work, patient flow and hospital efficiency.
• Identify patterns or trends that positively impact reduced readmissions.
• Assess patterns, trends or root causes of readmission for individual patients or across settings and refer to social worker, care manager, nursing, physician and others to proactively address patient‑specific issues to avert future readmissions.
• Incorporate evidence‑based knowledge to initiate change and participate in quality improvement activities.

• Adhere to hospital and departmental attendance and punctuality guidelines.
• Perform all job responsibilities in alignment with the core values, mission and vision of the organization.
• Perform other duties as required and complete all job functions per departmental policies and procedures.
• Maintain current knowledge in present areas of responsibility through ongoing education and training.
• Attend staff meetings and complete mandatory in‑services and competency evaluations on time.
• Demonstrate competency at all levels in providing care to all patients based on age, sex, weight and demonstrated needs.
• For non‑clinical areas, attend training and demonstrate usage of age‑specific customer service skills.
• Wear protective clothing and equipment as appropriate.