New

RN Behavioral Health Admissions Utilization Management

Corewell Health
United States, Michigan, St. Joseph
Apr 19, 2025
About the Unit This unit is a 26-bed inpatient behavioral/mental health unit. This unit's primary specialty is psychiatric and substance abuse disorder patients. The average length of stay is 7-10 days. The patient population will include depression, anxiety related disorders, substance abuse, and other mental health related behavioral issues. RNs will care for patients requiring refocusing and regaining mental health, inpatient rehab for substance abuse, and detoxification. Nurse to patient ratio 1:7 for regular BH patients, we may need you to be 1:1 or 1:2 or more depending on staffing needs and the acuity in the unit as a whole. About Corewell Health South - Lakeland Hospitals The health system comprises threehospitals, an outpatient surgery center, a regional cancer center, rehabilitation centers, two long-term care residences, home care and hospice services, and 34 affiliate physician practice locations. We provide both inpatient and outpatientmedical servicesthroughout Southwest Michigan. Job Summary Provides health information, interacts and acts as a resource for nursing units for complex clinical situations to ensure appropriate use of acute care services and diagnosis-related group (DRG) management. Assesses appropriateness of inpatient admissions and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and provides financial and utilization management (UM) information to other members of the care facilitation teams for work prioritization. Works closely with inpatient care facilitators and Medical Social Workers to move patients through the continuum appropriately. Oversees the intake for the acute care behavioral health unit and ensure the completion of admission paperwork, assessment and admission navigator in Epic. As an integral part of the BH team, attends daily team meetings, shares covered days for LOS determinations and has timely follow-up with insurance providers to gain extended stay coverage as needed. Participates in community relations development and process improvement, to include Riverwood and other local mental agencies. Essential Functions Oversees intake for the acute care behavioral health unit. Complete admissions paperwork, skin assessments, and physical assessments. Provides information and background to the assigned nurse about the new patients and communicating their needs including medication, special safety observation, and withdrawal protocol. Answers basic questions from patients and guardian regarding their admission and the unit. Interview new patients with patience and sympathy, while completing the admission navigator in Epic, including care planning, treatment planning, and progress notes, in a timely manner. Educating patients/guardian on their admission status (involuntary vs voluntary) and the unit schedule, rules, and regulations (including contraband rules). Is an integral part of the BH team, attends daily team meetings, shares covered days for LOS determinations and has timely follow-up with insurance providers to gain extended stay coverage as needed. Collaborates with internal and external sources to assure admission criteria, checklist, and legal documents for appropriateness. Assesses and interprets clinical information and assists in case management of complex patient population, through use of independent judgment, mature problem solving skills, and guidelines for appropriateness of acute care setting upon admission and continued stay. Adjusts patient registration status code, as needed, to maximize reimbursement and be consistent with regulatory standards. Communicates with physicians, medical social workers, and other hospital personnel concerning change in level of care on the medically complex patient population. Makes recommendations and discusses alternatives. Provides financial/DRG, UM, health information to other facilitation team members for work prioritization. Communicates and collaborates with physicians and members of the team to ensure continuity and coordination of services. Documents any instances where services were delayed, inappropriate, refused, complicated, etc. for resource management functions. Identifies quality indicators to facilitate process improvement and physician education. Coordinates with care management on admissions, on-going stay UM workflows, authorization, denial, and appeal process. Participates in community relations development and process improvement, to include Riverwood and other local mental agencies. Qualifications Required Associates in Nursing Bachelors in Nursing within 5 years 2 years of relevant experience acute care, clinical nursing, preferably multiple clinical settings, or related experience MI Registered Nurse (RN) #LI-CL #clinicalwest #CorewellHealthCareers How Corewell Health cares for you Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here. On-demand pay program powered by Payactiv Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! Optional identity theft protection, home and auto insurance, pet insurance Traditional and Roth retirement options with service contribution and match savings Eligibility for benefits is determined by employment type and status Primary Location SITE - Lakeland Hospital St Joseph - 1234 Napier Ave - St Joseph Department Name Behavioral Health - St Joseph Employment Type Full time Shift Day (United States of America) Weekly Scheduled Hours 40 Hours of Work 8 a.m. to 4:30 p.m. Days Worked Monday to Friday Weekend Frequency On-call weekends CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief. Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category. An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team. You may request assistance in completing the application process by calling 616.486.7447.