Physician Assistant, Jackson South Multispecialty, Full Time, Days

Position Summary:
Physician Assistant is professional technical work which relieves physicians of many essential and time consuming tasks. The incumbent interviews patients, takes medical histories, performs physical examinations, orders laboratory tests, makes diagnosis, prescribes appropriate treatment, provides postoperative care and assists during complicated medical procedures. Work is performed under the direct supervision of a physician.

Duties & Responsibilities:
Identifies patients to be case managed using MediFax, DDE or other system applying InterQual,M&R, First Health or other specific criteria related to diagnosis, clinical condition, cost and/orpayor. Follows unit specific policies and procedures. Participates in daily rapid rounds / clinicalrounds on inpatient population. Assesses / provides patient age specific needs and evaluateseffectiveness of care. Prioritizes/plans care based on knowledge of growth and development ofpatients served. Coordinates scheduling of pre-admission work-up / admission work up/elective/emergency procedures/surgery prior to surgical or procedure date. Assesses/plans forpatient care requirements throughout the continuum of care for specific diagnoses, procedures,DRGs and/or populations according to state and federal guidelines. Assesses complex patient careneeds/situations/acuity levels obtaining significant data from assessments (physical/functional,mental, psychosocial, environmental, family support, spiritual, cultural, financial, legal).Participates in care planning including discharge planning and determines appropriateinterventions/referrals. Assists with coordination of discharge follow-up as needed. Assessespatient needs to ensure services are appropriate to the condition/procedure/level of care and reportssignificant findings/seeks corrective action. Facilitates resolution of conflicts and problem solving.Identifies ethical dilemmas such as conflict of interest, and seeks appropriate resources/consultationto formulate decisions/solutions. Coordinates patient care throughout an episodic/continuous courseof care for a specific DRG/diagnosis/procedure/population using InterQual, M&R, First Health orother specific criteria and evidence based guidelines. Plans and coordinates access to care at thenext level in the care continuum. Facilitates continuity of care byorganizing/conducting/participating in patient care conferences. Facilitates the delivery of servicesin a timely and cost-effective manner using effective negotiating skills. Evaluates/monitors thelevel of care along the continuum of care (e.g. effectiveness of meds, treatments, pain status, plan)and individualizes the plan of care including teaching/discharge planning. Assists patients/family toappropriately self-direct care, self-advocate, and make informed health care decisions to the degreepossible in the ongoing plan of care. Assesses patient compliance with prescribed treatmentregimen and facilitates compliance as needed. Obtains authorizations / pre-certifications andcontinued stay authorizations as required. Demonstrates expertise with the KeyPro/First Healthweb based review procedures. Refers problem cases/denials to the Clinical Service Coordinator andappropriate medical/administrative team members. Applies the appeals management process asnecessary. Monitors patient progress throughout the episode of care for LOS, cost and variances, based on acuity and regulatory/legislative requirements (AHCA, DCF, CMS, JCAHO, CARF,HRSA, INS, US Armed Forces). Identifies practice issues based on evidence based guideline trends(clinical pathways/medical criteria/disease management protocols), and intervenes as necessarywith appropriate service management. Documents case management activities (i.e. HIS managedcare notes, HBOC, PRO internet websites, Esphere, Excel/Access spreadsheets, and abstracts).Participates in the development of disease management programs as appropriate. Coordinates andassists in the internal and external transfer of patients to other acute care, SNF, rehabilitation,psychiatric, residential, forensic, ALF, and/or other facilities. Develops an initial discharge planbased on assessment and cooperation with the patient, physician and other team members/agencies(i.e.. SW, PT, OT, RT). Coordinates and arranges for, consults with & refers to social worker orother health team member when appropriate. Coordinates, arranges, consults and refers to socialworker or other health team members for appropriate services post-discharge as indicated (i.e.ACLF, SNF, REHAB, HHC, DME, community case management, transportation, financialassistance, emotional support, medication, supplies etc.). Identifies system, practice and patientissues (including quality of care and quality of life outcomes) and collaborates in theirresolution/improvement with appropriate internal (JHS-Risk Management, Medical Records,Patient Finance, Medical Services, etc.) and/or external services or agencies (managed careorganizations, AHCA, DCF, CMS, JCAHO, CARF, HRSA, INS, US Armed Forces, etc.).Recommends/assists in the implementation of strategies (i.e.. evidence based practice guidelines) tocontrol LOS and/or resource utilization within the case managed population. Identifies theachievement of goals that are a direct result of case manager interventions. Maximizes patientoutcomes through incorporating community-based and non-benefit related services wheneverpossible. Prepares and distributes reports as required: utilization management reports, productivity,denial management, annual, LOS, clinical pathway, performance improvement, National Report ofQuality Indicators, transfer, high utilizer reports, etc. Communicates team recommendationsregarding practice and/or systems changes based on report. Identifies all members of the health careteam appropriate for the development of evidence based guidelines. Performs data analysis forDRGs, diagnoses, procedures, and/or populations using data systems including HCIA/Solucientreports, WinStat, ClinAff, Esphere, etc. Facilitates and coordinates evidence based guidelinedevelopment/revision activities (clinical pathways/medical criteria sets - InterQual, M&R, FirstHealth/disease management protocols) incorporating research findings. Critically evaluates theactivities and practice patterns of evidence based guidelines (clinical pathways/medical criteriasets/disease management protocols) utilizing case management resources and clinical expertise.Provides feedback related to evidence based guideline activities (clinical pathways/medical criteriasets/disease management protocols) to CRM department and related departments/health teammembers. Participates in outcome analysis as related to clinical services, functional status andfinancial resources. Evaluates/communicates outcome analysis to relevant administrative source.Utilizes an integrated system approach to case management across the continuum of care.Articulates information pertinent to clinical condition, LOS, outcomes, resource utilization,discharge planning, etc. at team meetings/presentations and to administration, medical director andphysician advisor. Demonstrates knowledge of the legal scope of practice of health caremembers/providers: JCAHO, AHCA, DCF, CMS, INS, law enforcement, Baker Act, etc. Acts inaccordance with legal principles of patient confidentiality, consent health care proxies, advancedmedical directives, and abuse/neglect in compliance with HIPPA and corporate complianceguidelines. Plans and coordinates multidisciplinary weekly/month/quarterly team meetings withinternal and external participants/agencies. Identifies the need for and participates in researchprojects as related to case management/disease management activities. Applies systematic use ofresearch methods to evaluate clinical resource management practice and studies the effectiveness of such interventions. Incorporates patient/family learning needs/readiness to learn, as well as, culturalbarriers and physical/cognitive limitations in the development/implementation of evidence basedcriteria tools. Informs patient/family/proxy/guardian of healthcare benefits/coverage as needed.Demonstrates knowledge of/acts as a patient advocate regarding financial class and payor groupsincluding healthcare benefits and coverage. Collaborates with Patient Financial Services regardingappropriate financial class and payor group. Evaluates the result of educational activities on patientoutcomes including LOS and resource utilization. Demonstrates behaviors of service excellenceand CARE values (Compassion, Accountability, Respect and Expertise). Performs otherrelated job duties as assigned.