Physician Assistant, Nursing Procedures-Jackson Main Hospital, Full Time, Nights

Department: Nursing Procedures
Address: 1611 NW 12 Ave, Miami, FL 33136
Shift Details: Full Time, Nights

Why Jackson:
Jackson Memorial Hospital is the flagship hospital for Jackson Health System and it has been a beacon of medical excellence and community care for more than a century. Throughout its rich and storied history, Jackson Memorial – located in the heart of the City of Miami – has been ground zero for some of the world’s greatest medical breakthroughs and important moments in South Florida. We’ve grown into one of the nation’s largest public hospitals, and one of the few that is also a world-class academic medical center with a proud mission and proven success. Jackson Memorial is an accredited, tertiary teaching hospital with 1,500 licensed beds, where nearly every medical specialty is provided by some of the world’s most skilled and highly regarded multidisciplinary team of healthcare professionals. 

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/or pay. 
• Follows unit specific policies and procedures. Participates in daily rapid rounds / clinical rounds on inpatient population. 
• Assesses / provides patient age specific needs and evaluates effectiveness of care.
• Prioritizes/plans care based on knowledge of growth and development of patients served. Coordinates scheduling of pre-admission work-up / admission work up/elective/emergency procedures/surgery prior to surgical or procedure date.
• Assesses/plans for patient care requirements throughout the continuum of care for specific diagnoses, procedures ,DRGs and/or populations according to state and federal guidelines.
• Assesses complex patient care needs/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 appropriate interventions/referrals.
• Assists with coordination of discharge follow-up as needed.
• Assesses patient needs to ensure services are appropriate to the condition/procedure/level of care and reports significant findings/seeks corrective action.
• Facilitates resolution of conflicts and problem solving. Identifies ethical dilemmas such as conflict of interest, and seeks appropriate resources/consultation to formulate decisions/solutions.
• Coordinates patient care throughout an episodic/continuous course of care for a specific DRG/diagnosis/procedure/population using InterQual, M&R, First Health or other specific criteria and evidence based guidelines.
• Plans and coordinates access to care at the next level in the care continuum.
• Facilitates continuity of care by organizing/conducting/participating in patient care conferences.
• Facilitates the delivery of services in a timely and cost-effective manner using effective negotiating skills.
• Evaluates/monitors the level 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 to appropriately self-direct care, self-advocate, and make informed health care decisions to the degree possible in the ongoing plan of care.
• Assesses patient compliance with prescribed treatment regimen and facilitates compliance as needed. Obtains authorizations / pre-certifications and continued stay authorizations as required.
• Demonstrates expertise with the KeyPro/First Health web based review procedures.
• Refers problem cases/denials to the Clinical Service Coordinator and appropriate medical/administrative team members.
• Applies the appeals management process as necessary.
• 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 necessary with appropriate service management.
• Documents case management activities (i.e. HIS managed care notes, HBOC, PRO internet websites, Esphere, Excel/Access spreadsheets, and abstracts).
• Participates in the development of disease management programs as appropriate.
• Coordinates and assists 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 plan based 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 or other health team member when appropriate.
• Coordinates, arranges, consults and refers to social worker or other health team members for appropriate services post-discharge as indicated (i.e.ACLF, SNF, REHAB, HHC, DME, community case management, transportation, financial assistance, emotional support, medication, supplies etc.).
• Identifies system, practice and patient issues (including quality of care and quality of life outcomes) and collaborates in their resolution/improvement with appropriate internal (JHS-Risk Management, Medical Records, Patient Finance, Medical Services, etc.) and/or external services or agencies (managed care organizations, AHCA, DCF, CMS, JCAHO, CARF, HRSA, INS, US Armed Forces, etc.).
• Recommends/assists in the implementation of strategies (i.e.. evidence based practice guidelines) to control LOS and/or resource utilization within the case managed population.
• Identifies the achievement of goals that are a direct result of case manager interventions.
• Maximizes patient outcomes through incorporating community-based and non-benefit related services whenever possible.
• Prepares and distributes reports as required: utilization management reports, productivity, denial management, annual, LOS, clinical pathway, performance improvement, National Report of Quality Indicators, transfer, high utilizer reports, etc. Communicates team recommendations regarding practice and/or systems changes based on report.
• Identifies all members of the health care team appropriate for the development of evidence based guidelines. Performs data analysis for DRGs, diagnoses, procedures, and/or populations using data systems including HCIA/Solucientreports, WinStat, ClinAff, Esphere, etc. Facilitates and coordinates evidence based guide line development/revision activities (clinical pathways/medical criteria sets - InterQual, M&R, FirstHealth/disease management protocols) incorporating research findings. 
• Critically evaluates the activities and practice patterns of evidence based guidelines (clinical pathways/medical criteria sets/disease management protocols) utilizing case management resources and clinical expertise. Provides feedback related to evidence based guideline activities (clinical pathways/medical criteria sets/disease management protocols) to CRM department and related departments/health team members.
• Participates in outcome analysis as related to clinical services, functional status and financial 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 and physician advisor.
• Demonstrates knowledge of the legal scope of practice of health care members/providers: JCAHO, AHCA, DCF, CMS, INS, law enforcement, Baker Act, etc.
• Acts in accordance with legal principles of patient confidentiality, consent health care proxies, advanced medical directives, and abuse/neglect in compliance with HIPPA and corporate compliance guidelines.
• Plans and coordinates multidisciplinary weekly/month/quarterly team meetings with internal and external participants/agencies.
• Identifies the need for and participates in research projects as related to case management/disease management activities.
• Applies systematic use of research 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, cultural barriers and physical/cognitive limitations in the development/implementation of evidence based criteria 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 groups including healthcare benefits and coverage.
• Collaborates with Patient Financial Services regarding appropriate financial class and payor group.
• Evaluates the result of educational activities on patient outcomes including LOS and resource utilization.
• Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise).
• Performs other related job duties as assigned.