ELMHS is the largest 24-hour, multi-site, state psychiatric complex, comprised of residential, outpatient, and inpatient services.

The official job specifications for this role, as defined by the State Civil Service, can be found here.

Job Duties:

70% PERFORMANCE IMPROVEMENT EFFORTS

• Facilitates, records, and leads PI projects & FMEA (Failure Mode & Effects Analysis) projects as assigned by        Director or Quality Council.  
• Assists PI Director with maintaining PI records, and ongoing documentation.
• Actively participates with surveyors during any on-site surveys, and assists in facilitating the survey process.
• Writes plan of correction and collect data.
• Conducts chart reviews and interviews for Sentinel Event “near misses” and/or Root Causes Analysis as Assigned by the Performance Improvement Director.  
• Serves as a Team Facilitator/recorder for Sentinel events or near misses as appointed by the Quality Director or   CEO. 
• Serves on various system-wide committees; including Clinical Department Head, and others as designated.  
• Collect and analyzes data related to assigned teams and projects
• Assists in the development of performance improvement education and training materials. 
• Audits charts as needed for compliance.  
• Assist with Joint Commission and Health Standards

10% CLINICAL RISK MANAGEMENT 

• Evaluates all seclusion/restraint/observation logs (including all types of restrictive patient management/patient observation data) for completeness and accuracy of information.
• Monitors that all parameters of restrictive patient management (RPM) are adhered to by all staff.
• Oversees the reporting process for easy retrieval and the entry of significant data into the computerized Patient Information Program (PIP), regarding the type of RPM, length of restriction, location, rationale, MD order, and other mandated information on both campuses.
• Ensures all seclusion and restraint data is entered by the ORYX deadline and checks for errors prior to the uploading of information to NRI headquarters.
• Clarifies outcomes with NRI and updates ELMHS administration regarding the acceptance I denial of the data submitted.
• Analyzes ELMHS seclusion and restraint data in comparison with the NRI and JC benchmarks, both statewide and nationally. Compile corresponding analysis reports for trends and patterns with graphic depiction (control and run charts where applicable) for presentation to various multi-disciplinary committees, departments chiefs and the administration.
• Conducts chart reviews and interviews for Sentinel Event "near misses" and/or Root Cause Analysis as Assigned by the Performance Improvement Director.
• Serves as a Team Facilitator/recorder for Sentinel events or near misses.
• Audits Treatment Plans for compliance with standards and incorporation of risk factors trended from the incident reports.
• Serves on various system-wide committees; including Clinical Department Heads, UR/QC, and others as designated.
• Actively participates with surveyors during any on-site surveys.
• Performs Joint Commission and CMS tracers in areas of clinical risk management (seclusion/restraint, major injury, death, major medication errors, adverse reactions, escapes, elopements, client to staff and client-client altercations, etc.) to assess ongoing compliance with regulatory and safety standards.
• Generate and analyze fall risk from incident reports.

10% UTILIZATION REVIEW / MEDICARE ACTIVITIES

• Performs admission reviews, continued stay and discharge reviews specified by CMS regulations to determine medical necessity and appropriateness of admission and continued stay for all Medicare and Private Insurance patients.
• Conducts admission reviews on Medicare and Private Insurance cases utilizing the "Magellan Hospitalization Inpatient Adult Criteria".
• Conducts concurrent reviews every 7 days for those Medicare acute unit patients.
• Provides Important Message from Medicare (IM): Within two days of admission and within two days prior to discharge, but no later than four hours before the patient leaves the facility.
• Compares findings with the level of care and diagnosis. Maintains files for those Medicare/Private Insurance clients served.
• Participates in any appeals processes as needed.
• Ensures concurrent reviews for those Medicare recipients admitted to the intermediate care settings are timely and continue to meet continued stay criteria as deemed per the Utilization Review Plan.
• Maintains the Physician Charge Ticket processes with regard to the Medicare covered Clients. Assures forms are available for completion and collected for processing on a routine, if not daily basis.
• Communicates with supervisor on utilization issues needing the attention of attending physician and/or treatment team staff.
• Gathers data collected in review for analysis and reporting to the Medical Staff, Utilization Review RN Manager and the QCIUR Committee. Check validity of data submitted.
• Assists with mortality reviews, as assigned by PIIUR Director.
• Completes retro reviews on cases reversed from initial denial as assigned.
• Analyzes insurance, governmental, and accrediting agency standards to determine criteria concerning admissions, treatment, and length of stay of patients; then compares inpatient medical records to established criteria and confers with medical personnel and other professional, clinical staff to determine legitimacy of treatment and length of stay.
• Serves as member of the system-wide QC/Utilization Review Committee, assists with agenda, and works closely with other members of the committee.
• Participates in development of policies and procedures, UR Plan, and monitoring forms with other UR staff
• Maintains functional relationship with Billing Office regarding service utilization.
• Actively performs an appropriate number of chart reviews monthly in order to ensure compliance with all CMS and Joint Commission requirements.
• Establishes internal procedures & policies for the collection and monitoring of information pertinent to compliance with licensure and services rendered to clients.
• Prepares monthly statistical reports indicating the number of Medicare/Private Insurance admissions, total admissions, number certified, number denied, continued stay justifications and number of discharge reviews.
• Participates with the UR/Medical Staff Care Studies as requested by PI/UR Director and/or Chief of Staff.
• Serves as back-up to other RN Program Coordinators responsible for Medicaid/OBH and Medicare utilization review duties in the East Division and other UR duties as assigned by the PIIUR Director.

5% IMPROVE SKILLS AND PURSUE JOB-RELATED EDUCATIONAL OPPORTUNITIES

• Meets competency requirements as defined by the organization.
• Performs self-reading and research into Quality Management, Joint Commission, CMS concepts and other job-related activities.
• Maintains compliance with PPD testing and other employee health standards.
• Maintains current RN license and obtains continuing education credits as needed.

5%     OTHER DUTIES

• Participate in education training that is mandatory for accreditation and licensure of the facility.
• Perform all other duties assigned by supervisor/designee to maintain continuity and quality, accreditation, and licensure requirements.  Perform all other duties assigned bythe  supervisor, but not listed, for the smooth operation of the unit/building and/or the facility.
• Maintains a current and unencumbered motor vehicle license.
• Adheres to all rules, regulations, policies, and procedures of LDH, OBH, Eastern Louisiana Mental Health System, and Civil Service.
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Position-Specific Details:

Appointment Type:  Detail to Special Duty only

*This posting may be used to fill vacancies in other divisions or units at Eastern Louisiana Mental Health System within 90 days of closing. 

Compensation: This position has a Special Entrance Rate (SER):
RN Program Coordinator – SER: $39.12/Hourly $3129.60/Biweekly

Louisiana is a State As a Model Employer (SAME) that supports the recruitment, hiring, and retention of individuals with disabilities.  

How To Apply:

Resumes will not be accepted in lieu of work experience.  An application may be considered incomplete if the work experience and education sections are not completed.  Please list all work experience.

No Civil Service test score is required in order to be considered for this vacancy.  

To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.

* Information to support your eligibility for the position must be included in the application (i.e., relevant, detailed experience/education).  Resumes will not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.

Contact Information:
For further information regarding this vacancy, please contact:

LDH- ELMHS/Human Resources
Jackson, LA 70748
225-634-0535