This position provides comprehensive management and coordination of care for patients requiring kidney, pancreas, liver, heart, lung or Stem Cell Transplantation The level and intensity of care coordination provided is situational and appropriate based on patient need and payor requirements.
Manages individual patients across the transplant health care continuum to achieve optimal clinical, financial, operational, and satisfaction outcomes. Facilitates, coordinates, and monitors pre-transplant evaluations, the care of the transplant candidate awaiting transplantation, the care of the transplant recipient post transplant in the outpatient clinic. Facilitates and coordinates the care of the living donor for evaluation, donation and long term follow-up. Collaborates effectively with the interdisciplinary team to plan and implement the patients treatment plan, utilizing effective oral and written communication.
Facilitates the safe, equitable and timely placement of donor organs in conjunction with the donor procurement agency on a 24 hour on call basis in accordance with the regulatory agencies. Possesses advanced knowledge of OPTN/UNOS regulations and allocation policies. Collects and communicates patient information necessary for decision making regarding organ acceptance/rejection for transplant with the organ procurement agency and transplant surgeon. Reviews potential recipients current medical status to determine eligibility for transplant. Demonstrates advanced prioritization and critical thinking skills in order to contact/locate patient(s), arrange admission and pre-surgery procedures, schedule surgery and the surgery team, and educate patient/family.
Interprets and administrates current payor contracts to best meet the financial needs of the patient and program while maximizing facility and program reimbursement. Possesses integral knowledge of multiple payor contracts. Applies this knowledge to assure that services being furnished to the patients are in compliance with contract stipulations. Obtains appropriate transplant authorizations for services rendered for each phase of the transplant.
Establishes and promotes a collaborative relationship with physicians, third party payers, and other members of the health care team, utilizing effective oral and written communication. Serves as a resource to payors, health care providers, patients, physicians and their office staff for the referral of patients or re-directs to alternate transplant programs as required by insurance constraints.Educates other health care providers, payors and patients on concepts of managed care, managed care networks, transplant networks, individual care policies as it pertains to solid organ transplant.
Serves as a resource to the community, patients, family members, potential living donors, primary care physicians and payers regarding the transplant process. Develops and presents education and marketing programs. Participates in community and professional education efforts to promote transplantation and organ donation.
Participates in the transplant programs quality assurance program. Evaluates current processes, identifies need for change and implements change via process improvement projects to achieve the optimal clinical, financial, operational and satisfaction outcomes. Acts as a change agent by continually monitoring processes to identify opportunities for improvement. Implements change through a multi-disciplinary work group process.
Requires current RN license in state of practice.
Requires a minimum of three years clinical nursing experience; at least two of those years in the clinical specialty area. Must have a working knowledge of care management, resource/utilization management, and hospital and community resources. Must demonstrate clinical proficiency in the care of transplant patients. Requires critical thinking skills to effectively coordinate a large volume of patients simultaneously. Must demonstrate problem-solving abilities, effective oral and written communication skills, and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format.
Bachelor's degree preferred
Additional related education and/or experience preferred.
Internal Number: 253289
About Banner Health
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.