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Patient Access Nurse Supervisor

Guidehouse • Los Angeles, CA • 7h ago

Job Family :

Patient Access Nurse

Travel Required :

None

Clearance Required :

None

What You Will Do :

The Patient Access Nurse Supervisor (PANS) will report to the Patient Access Director. The PANS will work directly along with the team, as well as oversees the Patient Access nurses in day to day operations to ensure they are facilitating patient medical and financial clearance using nursing knowledge, clinical judgment, and communication skills to assist in resolving difficulties surrounding patient access and authorization of services.

Duties and Responsibilities

Consistently and accurately utilizes medical acceptance criteria to screen Emergency Room patients in a way to ensure optimal efficiency in the Patient Access operations.

Performs clinical review of all inpatients to determine medical acceptance following the Miliman guidelines and communicates with patients, and physicians who fail to meet medical criteria for acceptance.

Uses excellent oral communication and listening skills to communicate with patient, physician and clinical staff regarding obstacles to access or financial clearance.

Review and updated department policies, procedures, training material and/or job aides, as needed.

Establish and maintain productivity and quality reporting

Provide real-time feedback to staff to facilitate a teaming and quality culture

Proactively lead by example, demonstrating quality and collaboration

Consistently maintain licensed nursing credentials

Facilitate a culture of teaming, collaboration and high ethical standards within the department and throughout the organization

Independently develop reports and presentations to support departmental needs

Responds to voicemails within one business day and answers phone calls in a timely manner.

Completely and accurately documents communications with payors, patients, and the treatment team.

Monitor Medicare One Day Stay admissions and report data trends to UM Committee

Perform audit reviews on team's MCG's to provide feedback and education to team members

Assists in monitoring and trending medical necessity denials and assist in creating action plans to reduce denial.

What You Will Need :

Bachelors Degree- preferably in Nursing

Active RN in State of California

7 years of prior relevant experience in Bed Board, Hospital or Nursing experience

What Would Be Nice To Have :

Masters Degree

Utilization Review Experience

1 year Supervisory/ Management Experience

The annual salary range for this position is $113,000.00-$188,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer :

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

Medical, Rx, Dental & Vision Insurance

Personal and Family Sick Time & Company Paid Holidays

Position may be eligible for a discretionary variable incentive bonus

Parental Leave

401(k) Retirement Plan

Basic Life & Supplemental Life

Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

Short-Term & Long-Term Disability

Tuition Reimbursement, Personal Development & Learning Opportunities

Skills Development & Certifications

Employee Referral Program

Corporate Sponsored Events & Community Outreach

Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse's Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant's dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

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