Clinical Access Nurse - RN; PRN

Job Summary

The Clinical Access Supervisor is the initial point of contact in the utilization management process and the access point for admissions. They coordinate patient care and resource utilization at the time of access to Lourdes, ensuring adherence to CMS requirements, managed care contracts, and admission guidelines. The role acts as liaison among admissions, surgery scheduling, physicians, and Medical Management, supervises departmental staff, assists in workforce planning, and supports compliance with established criteria and guidelines for appropriate resource utilization.

• Conduct Clinical Access Review: evaluate medical necessity and level of care using Interqual criteria for questionable admissions; understand criteria for admission, concurrent stay, and level of care subsets; ensure compliance with EMTALA/COBRA regulations for transfers from outside facilities.
• Promote quality and efficiency: stay current with trends through seminars, workshops, professional conferences, and affiliations with national and state professional organizations.
• Collaborate and partner with acute unit supervisors to notify them of potentially difficult cases and coordinate discharge planning upon admission; manage patient movement through the continuum of care to enhance quality and control resource utilization.
• Act as liaison between physicians and Medical Management at the time of access: query admitting physicians to determine medical necessity or desired level of care; direct physicians to appropriate alternative levels of care when admissions are questionable.
• Leadership and supervision: participate in hiring and training of department staff; assign and monitor staff work and schedules per policy; maintain attendance data for payroll; administer performance reviews; address employee relations issues; coach and mentor staff.
• Facilitate patient throughput in admissions, discharge, and transfer processes; coordinate and communicate critical information related to risk issues, guest service issues, or other necessary information with administration, risk management, medical management, medical staff, and patient advocates.
• Perform other duties as assigned or requested.
• Consistently perform 12 organizational Service Standards focused on values, service, and quality.

• Bachelor's Degree
• Registered Nurse (RN) – Current/unrestricted RN license
• BLS (Basic Life Support) Certification