PRINCIPAL DUTIES AND RESPONSIBILITIES: Executes the admission, discharge and transfer process by establishing patient placement priorities to facilitate patient flow and distribution in the most efficient and equitable manner possible, in order to maximize utilization of beds, and at the same time meet the medical needs of the patients.
Responsible for ensuring that all aspects of maintaining two hospitals (BWH & DFCI) within one building are in compliance with local, state and federal regulations, guidelines and mandates; including, but not limited to admission, discharge, transfer, room assignments, billing, and medical legal cases.
Interacts with sophisticated computer program developed to address the changes made to the Department of Medicine based on mandates of ACGME; entering data on each admission, the accuracy and completeness of the data is imperative to ensure that computer alerts are generated to the correct physicians.
Determines that all interhospital transfers are appropriate, including level of care needed, and arranges for adequate staffing levels and the availability of monitors, ICU beds, etc.
Determines eligibility for admission in compliance with hospital policy, utilization review criteria, and state and federal regulations and/or guidelines.
Ensures that adequate information is obtained in order to identify and resolve cases that pose potential financial risk to the institution. Refers complex issues to the Director of Patient Access Services, and recommends delay or deferral of non-emergent admissions when reimbursement cannot be assured.
Maintains dynamic census for Brigham and Women's Hospital and Dana Farber Cancer Institute inpatients to ensure accurate generation of charges and statistics. Prepares and reconciles daily census, identifies and resolves census and/or system issues to prevent loss of revenue.
Ensures a smooth-functioning, organized system of record keeping for all aspects of Patient Access Services including registration and admission.
Notifies physicians of their admissions, discharges and transfers to ensure accuracy of information and data integrity.
Maintains patient confidentiality and privacy by accessing patient information only to the extent necessary to fulfill assigned duties. Executes departmental policy in regards to HIPAA requirements. Ensures that all patient information is kept private, confidential and secure. Properly secures and stores all lists, reports, files and documents. Ensures that interviews and examinations are conducted in such a manner as to afford the patient reasonable audio and visual privacy. Adheres to Customer Service Standards by demonstrating professionalism, alertness, helpfulness and receptiveness to all patients, visitors and other staff members.
Establishes and maintains effective working relationships with all levels of hospital professional, administrative and support staff, as well as patients, their families and representatives of other organizations where considerable tact and persuasiveness must be employed to maintain patient confidentiality and overall harmony.
Performs special projects as assigned.
Acts as primary liaison for referring physicians and BWH MDs, and is responsible for decision-making about timing and urgency of admissions for patients
Coordinates hospital to hospital transfers and outside facility ED to BWH transfers in collaboration with the ED flow manager, Access Center Assistant Nurse Directors, and Nurse Administrators
Elicits patient information from referring MD and outside facility nurse to allow appropriate service for the patient and bed placement
Establishes and sustains successful external relationships with ancillary departments and referring physicians to assure smooth and efficient functioning of the schedule and excellent customer service to our referral base
Notifies team and inpatient service of admission via email to attending physicians
Facilitates referring physician callback for specific information
Receives back-up and decision support from the ED attending physician for potential inpatient admissions
Interfaces with patient access services to provide through-put and bed utilization services to enhance the patient experience, while optimizing patient flow
Reviews bed availability frequently, assigns patients, in collaboration with patient access services to appropriate beds based upon bed availability and triage information
Uses information to make proactive patient placement decisions
Updates physicians and transferring facilities on bed availability
Collaborates with Nurse Administrators and Access Center Assistant Nurse Managers regarding the Hospital flow of admissions from the ED and from OSH's
Completes written communication in the form of Expect Notes from the referring providers to ensure quality and safety, as well as, to initiate and streamline the transfer process
Completes all transfer request in the EPIC Transfer Module to maintain the tracking database
Bachelor's degree, preferably in health care related field. Extensive experience accepted in lieu of degree.
Three or more years experience in health care, preferably access management.SKILLS/ ABILITIES/ COMPETENCIES REQUIRED: Ability to use common sense, decision-making and negotiating skills to achieve desired results.
Ability to function independently and prioritize work within established policies.
Thorough knowledge of hospital and interdepartmental functions.
Technical knowledge of specific legal requirements and an understanding of complex third party and medical assistance policies and procedures.
Interpersonal relationship skills necessary to communicate effectively with patients, attending physicians and their support staff, medical staff, nursing staff administrators, other hospital personnel and external organizations and agencies.
Busy office environment, with frequent interruptions. Due to the size and complexity of the department, the pace of work can be hectic and challenging. SUPERVISORY RESPONSIBILITY:
Manages a very complex patient flow process, which becomes even more complicated during peak occupancy periods. FISCAL RESPONSIBILITY:
The key to the institution's reimbursement lies in the integrity of data collected. This position plays a crucial role in collecting, monitoring, and maintaining the information necessary to ensure timely billing and reimbursement. The position is also responsible for maximizing the utilization of available resources which contributes directly to the institution's financial viability.Qualifications
Bachelor's degree, preferably in health care related field.
Extensive experience accepted in lieu of degree.
Three or more years experience in health care, preferably access management.EEO Statement
Brigham and Women's Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, sexual orientation, protected veteran status, or on the basis of disability.