Job Title: RN/LPN & Prior Authorization

Supervisor: Director of HCCH Medical Group

FLSA Status: Non-Exempt /Full-time

Qualifications: Graduate of an accredited School of Nursing and possess one year of nursing experience, within the last five years. Must be currently licensed in the state of Missouri; maintain active BLS certification.

Positional Summary:

This individual will performance nursing duties for a Nurse Practitioner three days per week and two days performing prior authorization functions.

Job Descriptions/Essential Functions

Nursing functions:

• Provides nursing care to an assigned patient population under the guidance of a licensed mid-level or physician practitioner
• Assists in patient assessment in coordination with licensed mid-level or physician practitioner
• Documents patient care observations and activities according to professional standards and procedures
• Assists with patient registration and check-in process, conducts collection of biometrics such as pulse, pulse oximetry, temperature, blood pressure, patient chief complaint, medication history and reconciliation, allergy, past medical history, past surgical history, social history and documents data into EMR system in preparation for practitioners review
• Administers prescribed medications and treatments in accordance with nursing standards of practice under the supervision of licensed mid-level and physician level practitioner
• Assures quality of care by adhering to therapeutic standards; measuring health outcomes against patient care goals and standards; making or recommending necessary adjustments; following nursing philosophies and standards of care set by state board of nursing, state nurse practice act, and other governing agency regulations
• Assists provider with medical procedures as needed
• Ability to work in fast-paced environment; proficient with multi-tasking
• Ability to make decisions and initiate action under stress in critical situations
• Receives and responds to patient inquiries via telephone, patient portal, other methods
• Effective verbal, non-verbal, and written communication skills
• Performs patient education about diagnoses, treatments to patients level of education and preferred method of teaching
• Ability to positively and effectively interact with physicians, mid-level practitioners, other members of the health care team, fellow staff, patients, etc.
• Customer service oriented attitude and behavior
• Embraces and participates in teamwork-oriented environment
• Works as assigned with other providers in absence of assigned medical provider or as staffing coverage dictates; may float
• Pleasant, poised demeanor. Approaches all interactions with professional, positive, attitude
• Aids in identifying methods of improving patient care practice and workflow; communicates with supervisory staff
• Working knowledge of computerized medical software; ability to quickly learn new technologies and changes in electronic medical record (EMR) workflow
• Maintains clean, organized, well-stocked patient exam rooms and workspace. Observes asepsis techniques per state and federal nursing practice guidelines

Prior-Authorization functions:

• Responsible for providing accurate and complete data input for precertification requests for appointments/testing/medications/etc., complete appointment referral requests while providing excellent customer service
• Obtaining prior authorizations for appointments/testing/medications/etc
• Obtain appointments based upon referrals from physicians within HCCH Medical Group
• Accurately enter required information (clinical and non-clinical data) into the computer system
• Contact patients regarding appointment/testing/medications/etc
• Call back providers with precertification numbers as needed
• Send form letters to patients regarding patient’s appointment, testing, and medications
• Maintain patient confidentiality as defined by state, federal and HCCH regulations
• Actively support departmental and organizational strategic plans and ensure successful implementation
• Maintain cooperative working relationships within and outside the organization
• Provide back-up to existing staff
• Working knowledge of computerized medical software; ability to quickly learn new technologies and changes in electronic medical record (EMR) workflow
• Demonstrates professionalism by: articulating & demonstrating professional behavior, accepting responsibility & accountability for actions, and ability to positively and effectively interact with physicians, mid-level practitioners, other members of the health care team, fellow staff, patients, etc
• Ability to work in fast-paced environment; proficient with multi-tasking, ability to work independently
• Effective verbal, non-verbal, and written communication skills
• Follows all Harrison County Community Hospital District and departmental policies and procedures
• All other duties as assigned by supervisor(s)