11 May Med/Surg Director Utilization Review (UR) / Discharge Planning (DC) / Swingbed Coordinator

Manages and supervises the Med/Surg Department and the services it provides to assure optimal standards of patient care and nursing practice. Assist with the education and staff development for the Med/Surg and Swingbed Department, and the Hospital District as needed. Assist with the development  of department policy, procedures, and practices. Monitors and compiles information on admission and continued stay. Under direction of the medical staff plans, organizes, and implements the discharge planning for patients being discharged from the hospital. Determines the patient’s needs for post hospitalization care, support assistance, and takes action to fulfill identified needs.

Reports to: CNO, CEO
Supervises: Med/Surg and Swingbed Staff

Physical and Mental Requirements

• Intermittent periods of sitting and standing
• Lifting/carrying >= 50lbs
• Periods of stooping/kneeling
• Occasional periods of high stress levels

Education Requirements

• Graduate of an Accredited School of Professional Nursing.

Licensure, Registry, Certification

1. Registered Nurse licensed by the State of Texas or eNLC
2. BLS, PALS, AND ACLS

Experience

1. Three (3) years experience as a charge nurse in a hospital setting.
2. Experience in Quality Assurance or Utilization Review activities preferred.

Primary Responsibilities & Essential Functions

Assists CNO in any department function requested to include direct patient care procedures.

1. Follow proper body substance isolation techniques.         
2. Provides service direct to patients while maintaining a positive patient relations atmosphere.

Assists in the planning, organization and direction of the provision of patient care services.

1. Assists with the developing and maintenance of nursing practice that is consistent with the Nurse Practice Act for the State of Texas.
2. Confers with the CNO and other department staff members to establish standards of patient care and to describe and evaluate the over all

Maintains records and supports the hospital in utilization matters

1. Completes accurate, timely records for submission to the business office to coordinate billing flow between the hospital and outside agencies.
2. Assists by providing information and utilization records in appeals for redetermination.
3. Prepares and presents education sessions and materials for medical staff members and the hospital staff.
4. Assists with interaction of all fiscal intermediaries regarding utilization review activity.
5. Compiles and reports statistics to the Utilization Review Committee.

SWING BED COORDINATOR
Performs duties in support of the Swing Bed function.

1. Acts as patient advocate for the patients in the Swing Bed Program.
2. Applies a standard of care for Swing Bed patients.
3. Updates and institutes Swing Bed policies and procedures as needed, participates in the formulation of new policies and procedures.
4. Completes patients’ initial assessments on each new admission witan 24 hours of admission date.
5. Schedules an coordinates the weekly conferences of the various personnel directly connected with the Swing Bed program to assess their activities.
6. Maintains quality of Swing Bed patients’ records.
7. Assists in the development of a multi-disciplinary plan of care for each patient.
8. Assures that patients are receiving  needed care while maintaining program solvency.
9. Reviews and revises plan for nursing care and treatment as needed.
10. Oversees rehabilitative/restorative nursing services directed toward achieving and maintaining optimum levels of patients’ functioning and independence.

Identifies patients that require post hospitalization care and assistance.

1. Consults with physicians, families, patients, and members of the healthcare team concerning patients’ needs.
2. Interviews patients who have been identified as possibly having a need for continued care.

Determines types of needs or assistance required by each patient and takes appropriate action.

1. Works with the health care team in developing and coordinating follow-up programs for the orthopedic, cardiac, disabled, or any patient needing continued care.
2. Determines patients’ eligibility for assistance provided by federal, state and community resources.
3. Completes necessary forms and makes arrangements for assistance when possible.
4. Assists families and coordinates arrangements for follow-up care from agencies such as Home Health, DHS primary care, and skilled nursing facilities.
5. Assists in securing assistance to meet the needs for food, transportation, clothing, temporary lodging, and medical appliances.

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