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Clinical Evaluator (Brooksville Market)

Job Description

Promise Hospital of THE VILLAGES:  The Clinical Evaluator is responsible for collecting and evaluating clinical information and assists in the determination of appropriateness for admission to the facility based on independent discretion and knowledge of InterQual criteria. In addition, he/she evaluates and communicates special needs, potentially high-risk cases, physician and/or insurance objectives, and patient/family dynamics and expectations to the Vice President of Physician Relations & Education and Nursing Management.       


QUALIFICATIONS:



  1. Current state license as either a Registered Nurse, Licensed Practical Nurse, Respiratory Therapist or Physical Therapist

  2. Two or more years of hospital clinical experience, preferably in an acute care setting

  3. Minimum of one year proven successful Marketing/Sales experience in a healthcare setting


  4. Ability to collect clinical information and apply criteria for potential admission including estimated length of stay, patient/family expectations, and discharge plans


  5. Strong medical assessment skills

  6. Experience in commercial insurance, Medicare and Medicaid reimbursements is preferred

  7. Experience in in-service education and public speaking

  8. Experience in Utilization Review and/or Case Management

  9. Understanding of InterQual and LTACH criteria for admissions and continued stays

  10. Must have a valid drivers license and a clean motor vehicle record, as well as carry applicable insurance as required by state law

  11. Must be able to read, write, and speak English, Bilingual desired     


PHYSICAL AND MENTAL REQUIREMENTS:


Physical:        Walking - up to 75%           Standing - up to 25%         Kneeling - up to 15%


                        Sitting - up to 50%              Pushing - up to 15%          Bending - up to 10%


                        Squatting - up to 10%        Pulling - up to 15%             Reaching - up to 15%       


                        Lifting - up to 50lbs             Wrist/Finger Movements - up to 90%      


Mental:           Stress Level: Moderate to High


EXPOSURE RISK:             Category II - Jobs in which required tasks normally do not involve exposure to blood, body fluids or tissues but which could result in Category I exposure.


EQUIPMENT, TOOLS, MATERIALS, MACHINES USED: Pager, cell phone, copier, fax, basic computer skills, understanding of electronic charting, wireless communication


CERTIFICATIONS:RN, LVN/LPN, PT, RT


#ZR



Company Description
Promise Healthcare specializes in long-term acute care (LTAC) hospitals. With an interdisciplinary team approach, our treatment plans are specifically designed for patients who need a longer acute care recovery period. We specialize in the medical management of patients with complex, unresolved, acute, or chronic illnesses as well as multi-organ disease processes.



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