Job Description

Job Title: Care Facilitator
Department: Case Management
Location: Gouverneur Hospital
Hours Per Week: 40 scheduled weekly hours
Schedule: 8-hour day shifts from 8:00 am - 4:30 pm, Monday-Friday

Comprehensively plans with the health care team to ensure patient needs are met and care delivery is coordinated across the continuum. Identifies and works to eliminate/minimize system variation and service delivery barriers that prevent achievement of optimal patient outcomes in the expected time frame and with most efficient utilization of resources. Carries out activities related to utilization management, discharge planning, care coordination and referral to other levels of care. Performs as an integral part of the interdisciplinary team promoting interdisciplinary collaboration and champions service excellence. Facilitates assignment of level of care, considers payer requirements and responds accordingly to avoid adverse financial consequence to patient and hospital. Provide superior customer service by modeling the Brand Promise and Core Values.

RESPONSIBILITIES:

• Conducts clinical reviews using Interqual criteria to determine appropriate patient level of care, document medical necessity, and support reimbursement.

• Monitors resource utilization through continued stay reviews, manages length of stay, and coordinates with Physician Advisors for complex cases.

• Serves as a liaison between hospital and payors, ensuring accurate communication of clinical information, supporting appeals, and optimizing benefit use.

• Collaborates with care teams to resolve barriers to care, participates in daily huddles, and uses data to identify opportunities for process improvement.

REQUIRED QUALIFICATIONS:

• Diploma from an accredited nursing school program or Associate's Degree

• 3 years acute hospital care experience

• Licensed in New York State as a Registered Nurse

PREFERRED QUALIFICATIONS:

• Case Management or Utilization Management experience

• Bachelor’s Degree

EDUCATION:

LICENSES / CERTIFICATIONS:

BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education Department (NYSED)New York State Education Department (NYSED)New York State Education Department (NYSED)

PHYSICAL REQUIREMENTS:

M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

$70,000.00 - $95,000.00

CITY:

Gouverneur

POSTAL CODE:

13642

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.