OTHER DUTIES AND RESPONSIBILITIES
Reviews denials of coverage to assess if there is documentation to support an appeal, or to determine what needs to change in the documentation.
Assists Supervisor in writing appeals and submitting information to payers as needed.
Educates casual staff regarding documentation and facilitates compliance.
Collaborates with psychiatrist regarding discharge criteria or length of stay.
Prepares patients for discharge from admission through their length of stay.
Works with therapist and outside agencies for follow-up care concerns. Assists program supervisor with Quality Assurance/Quality Monitoring.
Attends Coordination of Care meetings.
Prepares for and attends Weekly Team Meetings.
Coordinates medical issues for patients with his/her Primary Care Physician.
Provides educational groups related to medication and healthy living. Sleep.
Diet – including topics such as shopping, meal plans, healthy eating habits, exercise and activity, stress management, etc. Participates in marketing program as time permits.
Assists in staffing marketing booth at fairs, seminars, etc..
Answers public inquiries about the program Complies with MyMichigan Medical Center Midland policies and procedures
Adheres to all policies and procedures related to employment, safety, program provision and operations.
Is familiar with the Michigan Mental Health Code as it relates to: recipient rights, confidentiality, abuse and neglect, and Duty to Warn.
MyMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft® Windows and other technology.
An employee may be required to participate in further learning opportunities offered by MyMichigan Health.
REQUIRED EXPERIENCE, TRAINING AND SKILLS
Licensed as a Registered Nurse in the State of Michigan. BSN/MSN Preferred.
BLS certification is required within one month of hire. Must follow MyMichigan Health bloodborne pathogen and TB testing as required Mandatory Occupational Safety and Health Administration (OSHA) training must be completed annually according to the Exposure Control Plan.
Mandatory Recipient Rights training within 30 days of hire and annually.
Mandatory conflict avoidance and physical management (CPI) within the first 30 days of hire and annually.
PREFERRED EXPERIENCE, TRAINING AND SKILLS
Previous utilization management experience is preferred. Must be proficient with computer skills and applications. Knowledge of data analysis is preferred. At least two years of recent clinical experience in psychiatric nursing.
PHYSICAL/MENTAL REQUIREMENTS AND TYPICAL WORKING CONDITIONS
Is regularly required to move freely about the unit and hospital. May be required to physically aid patients, including lifting. Overall vision is necessary, including color and depth perception, reading and close?up work and a peripheral field of vision. Overall dexterity is required, including handling, reaching, grasping, fingering and feeling. Hearing and speech are necessary, including on the phone as well as in person and faint sounds. Emotional stability is a must, due to frequent exposure to stressful situations; trauma, grief and death, public contact, decision making and high level of concentration. May be exposed to blood borne pathogens and other potentially infectious material. Able to work in latex environment. Able to wear personal protective equipment that may include latex materials or appropriate substitute
