Description All nursing practice is based on the legal scope of practice, national and specialty nursing standards, CNMC Policies and Procedures, and in accordance with all applicable laws and regulations.
The Professional Model of Care requires registered professional nurses to be responsible and accountable for their own practice.
CNMC supports the development of RN relationships within the community; specifically, those relationships associated with the health and well-being of the community at large.
Responsible for daily operations (staffing and assignments) and directing the activities of the Clinical Resource Management department.
Provides 24-hour accountability for planning, managing and evaluating department functions.
Guides, supervises and elevates the quality of practice for utilization review within Children's National.
Key areas of focus include use of nationally recognized criteria sets, status changes and concurrent denial management.
Qualifications Minimum Education
Bachelor's Degree (Required)
Master's Degree (Preferred)
Minimum Work Experience
5 years Nursing experience (Required)
1 year Pediatric experience in a comparable setting (Required)
1 year Demonstrated nursing leadership experience (Required)
Required Skills/Knowledge
Familiar with software such as Window's environment (Microsoft Office, Word, PowerPoint, Excel, Access).
Excellent oral and written communication skills.
Fluent in medical management criteria such as MCG and/or InterQual.
Required Licenses and Certifications
Registered Nurse in District of Columbia .
Functional Accountabilities
Professional Practice/Research
Facilitate the CMI practice group of Shared Nursing Leadership and support other initiatives.
Contribute to the sustainability and advancement of Magnet designation.
Ensure that utilization review for patient status (IP and Observation) is based on evidence of best practice.
Accountable for supporting/participating in the CRM and/or Division of Nursing's Performance Improvement processes.
Participate in community activities.
Daily Operations
Accountable for staffing and assigning coverage for all roles within CRM; engages with CMI Team Lead, Manager & Director to problem solve.
Responsible for 24/7 assessment and supervision of work flow for CMI's and support positions.
Supervise utilization review activities, interface with internal and external stakeholders to achieve appropriate level of care and optimize reimbursement; ensure compliance with CMS regulations.
Interact with payors and CRM leadership to improve the authorization process.
Engage in performance improvement activities to standardize and elevate practice.
Communication
Demonstrate advanced communication skills in dealing with staff and all members of the healthcare team.
Provide constructive, sensitive and timely feedback to staff concerning their performance in verbal and written form.
Effectively manage conflict and assist others to understand their behavior and their effect on the work environment.
Communicate and escalate issues as appropriate to the Manager and Director.
Staff Education
Facilitate learning opportunities for staff.
Participate in the education and training of Case Managers and other staff.
Safety
Speak up when team members appear to exhibit unsafe behavior or performance
Continuously validate and verify information needed for decision making or documentation
Stop in the face of uncertainty and takes time to resolve the situation
Demonstrate accurate, clear and timely verbal and written communication
Actively promote safety for patients, families, visitors and co-workers
Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance
Organizational Accountabilities
Management and Leadership Skills
Monitors Kronos reconciliation and ensures schedule and timecard accuracy
Responsible for all aspects of performance appraisal for designated staff
Participates in the hiring of staff by completing WFM paperwork, conducting interviews and making recommendations for hire
Assumes coverage of unit in absence of Manager & Director and makes decisions within authorized scope
Demonstrates initiatives and leadership through involvement in department based projects and committees
Establishes collaborative relationships and network across the organization to ensure effective outcomes
Represents CRM on organizational committees and initiatives
Organizational Commitment/Identification
Partner in the mission and upholds the core principles of the organization
Committed to diversity and recognizes value of cultural ethnic differences
Demonstrate personal and professional integrity
Maintain confidentiality at all times
Customer Service
Anticipate and responds to customer needs; follows up until needs are met
Teamwork/Communication
Demonstrate collaborative and respectful behavior
Partner with all team members to achieve goals
Receptive to others' ideas and opinions
Performance Improvement/Problem-solving
Contribute to a positive work environment
Demonstrate flexibility and willingness to change
Identify opportunities to improve clinical and administrative processes
Make appropriate decisions, using sound judgment
Cost Management/Financial Responsibility
Use resources efficiently
Search for less costly ways of doing things
Organizational Accountabilities (Staff)
Organizational Commitment/Identification
Teamwork/Communication
Performance Improvement/Problem-solving
Cost Management/Financial Responsibility
Safety Primary Location : District of Columbia-Washington Work Locations : CN Hospital (Main Campus) 111 Michigan Avenue NW Washington 20010 Job : Nursing Organization : Surgery COE Position Status : R (Regular) - FT - Full-Time Shift : Day Work Schedule : Monday-Friday 7am-5:30pm 4 days per week Job Posting : Aug 29, 2024, 3:46:43 AM Full-Time Salary Range : 89752 - 149593.6
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