Company: Vail Health
Posted on: November 19, 2022
To us, it's about living life to the fullest while serving our
patients, teammates, neighbors and friends. We are dedicated and
passionate in everything we do, seeking challenge and appreciating
the routes that got us here. Whether our path is clinical or not,
we all came to find balance and meaning in our lives within the
work we are passionate about and the adventures we live.
Vail Health has become the world's most advanced mountain
healthcare system. Our updated 520,000-square-foot hospital opened
in December 2020. This state-of-the-art facility provides
exceptional care to all of our patients, with the most beautiful
views in the area, located centrally in Vail.Salary: $39.35 -
$59.02 / hourly. Pay is based upon relevant education and
Maximizes reimbursement for both patient and hospital through
cooperation with third party payers and physicians. Follows up on
denials based on resource utilization issues. Provides a smooth
transition for the patient from hospital to home or alternative
care setting through coordination of services to meet the post
discharge needs identified while maintaining a balance among
quality outcome, cost, and process. Identifies those patients with
significant psychosocial needs and makes referrals to Social
Services. Promotes continuous quality improvement by monitoring
team processes as well as through communication with other teams
impacted by or impacting the processes of this team.
ESSENTIAL JOB FUNCTIONS:
- Monitors for appropriateness of admission, continued stay, and
readiness for discharge based on department defined guidelinesand
criteria as evidenced by appropriate documentation. Demonstrates
utilization review accuracy using Interqual criteria.
- Informs the patient and the attending physician when the
patient doesn't meet acute care criteria according to department
- Cooperates with other departments in defense of denial of
services by reviewing the chart for documentation of
appropriateness ofthe admission/continued stay as evidenced by
provision of supporting chart documentation.
- Communicates with attending physicians when necessary.
- Identifies the post-hospital equipment and unmet care needs of
the inpatient and The Medicare patient (including
observation)beginning within 24 hours of notification of admission
as evidenced by placement of the completed discharge planning
needsassessment form in the social service section of the
- Identifies the psychosocial needs of the patient and/or family
and addresses those needs or make a referral to social services
asappropriate as evidenced by documentation on the discharge
planning needs assessment form.
- Identifies the unmet financial needs of the patient and
addresses those needs or make a referral to Inpatient
AdmissionsRepresentative for HELP program or Social Services as
- Ensures that no services are denied for lack of clinical
information when accurate contact numbers are received from
InsuranceVerification within the payer's time-frame as evidenced by
absence of denials which fall within the above guidelines.
- Follows-up with patients within 14 days post-discharge where
discharge planning referrals were made to identify the adequacy
/flaws in the process.
- Role models the principals of a Just Culture.
- Perform other duties as assigned. Must be HIPAA compliant
This description is not intended and should not be construed to be
an exhaustive list of all responsibilities, skills and efforts or
work conditions associated with the job. It is intended to be an
accurate reflection of the general nature and level of the job.
- One year recent experience in acute care hospital Utilization
Review, Discharge Planning or equivalent.
- Two years experience in case management if incumbent is a
Licensed Practical Nurse (LPN).
- Licensed as a Registered Nurse in the state of Colorado or from
a valid compact state OR licensed as a Licensed PracticalNurse in
the state of Colorado required
Computer / Typing:
- Must possess, or be able to obtain within 90 days, the
computers skills necessary to complete online learning
requirementsfor job-specific competencies, access online forms and
policies, complete online benefits enrollment, etc
Must have working knowledge of the English language, including
reading, writing, and speaking English.
- Associates or Bachelor's degree in nursing.
- Able to pass annual inter-rater reliability competency exam
(IRR) with a score of 80%.
Benefits at Vail Health
- Competitive Wages & Family Benefits: Competitive wages,
parental leave, housing programs and childcare reimbursement to
support the cost of living in a mountain community.
- Comprehensive Health Benefits: Top-quality health care package
including vision, dental and medical with options of flexible
spending and health savings accounts.
- Education Assistance: We are proud to offer tuition and student
loan assistance programs.
- Paid Time Off: Roughly five weeks in your first year of
employment and continues to grow each year.
- Retirement & Supplemental Insurance: 403(b) Retirement plan
with matching potential, life insurance, short and long-term
disability, and more.
- Recreation Benefits, Wellness & More: Recreation discounts, pet
insurance and a $1,000 annual wellness reimbursement program.
As a condition of employment, Vail Health requires COVID-19
vaccination of all clinical and non-clinical staff.
- - - - - -
Vail Health, formerly Vail Valley Medical Center, is a nonprofit
community health care system serving patients and guests from
around the world. Locally operated and governed by a volunteer
board of directors, Vail Health includes a 56-bed hospital,
accredited by the Joint Commission. Our 24/7 emergency department
in Vail is a Level III Trauma Center with a nearby helipad for
necessary medical transports.
Vail Health provides a wide array of services and access points
including Beaver Creek Medical Center, urgent care clinics in Avon
and Gypsum, our Edwards medical campus, Eagle Healthcare Center and
a multispecialty clinic in Frisco. Howard Head Sports Medicine
offers physical therapy services at 10 locations and works closely
with our internationally renowned orthopaedic partners at The
Steadman Clinic and Vail-Summit Orthopaedics. In addition, Vail
Health's Shaw Cancer Center and Sonnenalp Breast Center are the
region's only fully accredited cancer treatment center and
comprehensive breast center.
The Vail Clinic, which was founded in 1965, officially became "Vail
Valley Medical Center" in 1980, its first year as a full-service
hospital. At that time, we had one primary location and 25
physicians. Today, Vail Health has locations in nine towns, 1,500
employees, 260 physician partners and 85 volunteers.
Keywords: Vail Health, Vail , Case Manager, Executive , Vail, Colorado
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