Patient Service Representative - Utilization Review

Advanced Practice Provider - Nurse Practitioner / Physician Assistant, Consults

Mary Free Bed Rehabilitation Hospital · SparrowLansing, MIProfessional / PhysicianFull-Time, Days, Salaried / Exempt - M-F, Weekend RotationReq # 12615

The Advanced Practitioner Provider will be responsible for working with assigned inpatient and / or outpatient physicians at locations within the Mary Free Bed Network where they have privileges.

Maintains a collaborative practice arrangement with the assigned physician(s). Provides independent judgment in the assessment, diagnosis and initiation of selected protocols / procedures.

Provides educational support for patients / significant others, team members and the community liaisons. Coordinates quality improvement studies to measure outcomes of care and develops research opportunities.

Essential Job Responsibilities

• Clinical Required : Provide patient care, treatment, and services within the scope of their license, certification or registration and as required by Federal and State laws and regulations.
• Functions in the role of Advanced Practitioner Provider to provide coordinated comprehensive care delivery in both the inpatient and outpatient setting.

Writes orders / prescriptions for standard formulary medications, laboratory studies, radiographic studies and consultations, coordinating the scheduling of new patients, diagnostic evaluations, follow-up exams, laboratory tests, referrals to home care, social services, and other community agencies, etc.

in order to ensure continuity of care and coordination of services for patients.

Screens new patients referred to gather pre-appointment clinical information and functional status / priorities for the appointment.

Shares responsibility of staffing patient return visits with other providers.

• Provide services in the inpatient setting which may include, but are not limited to :
• Performing Admission History and Physicals as assigned
• Rounds on assigned patients, documenting and communicating with physician and other team members as appropriate
• Complete inpatient consult requests, records reviews, and patient screenings to determine appropriateness for inpatient admission
• Participates in team conferences
• Performs clinical duties in the outpatient setting, including such activities as :

o Provide medical care for scheduled patients

o Communicating lab tests, x-rays, MRI, and other specialty evaluations to the other team members.

o Formulating a problem list, and updating this at each contact.

o Arranging medication, lab work, medical evaluation, or other orders prescribed by the physician.

o Coordinating referrals for social work or other community resources.

o Communicate assessments, test results, and plan of care with patients, family members and care team members.

o Receiving telephone calls or other inquiries from the patient, evaluating the problem, and developing a plan of care.

When assigned leads the inpatient multidisciplinary wound round team; provides consultation and input into protocols to be implemented for patient care;

provides consultations when requested by attending physicians.

• Documents in the medical record and dictates information as appropriate. Demonstrates competence in navigating and appropriate documentation in electronic medical record.
• Assesses the educational needs of the patients, significant others, health care team, and the community. Develops, implements, evaluates and revises teaching strategies and educational programs specific to the patient’s medical and psychosocial needs.
• Measures the outcomes of care and evaluates services across the continuum of outpatient services. Makes recommendations to improve the quality of patient care provided and utilizes the scientific method to research clinical problems.
• Maintains knowledge of current trends and developments in the field by reading appropriate books, journals and other literature and attending related conferences, seminars and other related activities.

Maintains the professional competence, knowledge, and skills necessary for all responsibilities. Completes required training and education, including department specific requirements.

• Ensures that services are provided in accordance with state and federal regulations, organizational policy, and accreditation / compliance requirements.
• Performs such individual assignments as management may direct. Establishes and maintains effective working relationships within the organization.

Provides information to senior levels of management on the implication of policies and procedures being formulated and recommends specific action.

Acts as a patient advocate, crossing multidisciplinary lines to meet patient needs. Communicates, collaborates, networks with and acts as a consultant to other members of the health care team within and outside Mary Free Bed Rehabilitation Hospital.

Acts as a consult in area of expertise.

• Serves as a resource for patients, families, team members, and community for information related to patient populations served.
• Participates in program development and service recovery as needed.
• Embrace Diversity, Equity and Inclusion, by :

Treating everyone with dignity and respect

Opening more doors to opportunities for underrepresented cultures

Growing talent and people

Evaluating and eliminating disparities

Taking action against injustices, bias and racism

Honoring our differences and how to collaborate

Educating staff, patients and the communities we care for

Restoring Hope and Freedom, together

Essential Job Qualifications

• Certified and licensed as a Nurse Practitioner (NP) or Physician Assistant (PA) by the State of Michigan.
• Master’s Degree in Nursing or Physician Assistant.
• 3-5 years of experience with neurologically impaired patients
• Current Basic Life Support (BLS) certification

Preferred Job Qualifications

• Previous experience as a NP or PA.
• Previous experience functioning in a collaborative role
• Excellent problem solving and initiative
• Excellent organizational and time management skills
• Excellent verbal and written communication skills
• Previous experience in quality improvement and research

Physical Requirements for Essential Job Qualification

Levels :

• None (No specific requirements)
• Occasionally (Less than 1 / 3)
• Frequently (1 / 3 to 2 / 3)
• Majority (More than 2 / 3)

Remain in a stationary position : Occasionally

Traverse or move around work location : Occasionally

Use keyboard : Occasionally

Operate or use department specific equipment : Occasionally

Ascend / Descend equipment or ladder : None

Position self to accomplish the Essential Functions of the role : Occasionally

Receive and communicate information and ideas for understanding : Majority

Transport, position, and / or exert force :

Up to 10 pounds : Frequently

Up to 25 pounds : Frequently

Up to 50 pounds : Occasionally

Up to 75 pounds : Occasionally

More than 100 pounds : Occasionally

Other weight : Up to pounds

Other :

The above statements are intended to describe the general nature and level of work being performed by employees in this classification.

If you require a reasonable accommodation to perform the essential functions of this position, you must request accommodation in writing, within 182 days after you know or should know of the need for accommodation.

Mary Free Bed is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, genetic information, veteran status, disability or other legally protected characteristic.