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Performs Diagnostic Radiographic Procedures according to department protocols, HFAP/TJC/local regulatory/CMS, State and Federal Regulations. Functions as the first line interface with customers and is successful in the accomplishment of their imaging needs. Participates in PI/QC activities. Responsible for processing and transmission of images to PACS.
The Operating Room Tech is responsible for the preparation of sterile supplies and instruments for each assigned procedure, maintaining sterile field during case and providing surgeon with sterile supplies and instruments during assigned procedures.
Responsible for the quality and resource management of all authorizations and referrals with the Prime Healthcare Employee EPO. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost-effective outcomes and to perform a holistic and comprehensive review of the medical record for the medical necessity, intensity of service and severity of illness.
The Vice President of Health Plan Claims and Operations is responsible for the development and execution of Claim Operations strategies, end-to-end Claim process automation, optimization and management, identifying and leveraging technology and data to improve the quality and minimize process cost of Claims for all Prime Healthcare’s self-insured Employee Health Plans. Through in-depth audit and review of Claims data, the VP will identify financial savings across all aspects of the Employee Health Plans.
The VP of Health Plan Claims and Operations will provide strategic leadership and development of the Claims Department and its employees, as well as collaborate with Network Development, Provider Affiliation and Member Relations, Contracting, and Benefits Administration to ensure data integrity and to drive financial and operational value across Employee Health Plans to maximize benefit coverage while containing cost.
The VP of Health Plan Claims and Operations will partner with local C-Suites and Hospital Administration to execute goals and plans of the Employee Health Plans. Through inter-professional collaboration, The VP will ensure that TPA and Health Plan are notified in a timely fashion of any changes in process or procedures which would impact their functions.
The Corporate Director of Clinical Utilization Management (UM) provides comprehensive oversight of the Utilization Review process for the self-insured Employee Health Plans, according to the EPO Plan Documents and any other applicable documents. Integrates and coordinates services using continuous quality improvement initiatives to promote positive member outcomes. Frequent executive level reporting and tracking on department and individual team productivity. The Corporate Director of Clinical UM assesses needs, plans, communicates, designs services and strategies to forward the mission and serve member needs. The Corporate Director provides strategic leadership, development, and supervision to utilization review department, provides interprofessional collaboration with facility-based case managers and discharge planners, and coordinates with all aspects of the Employee Health Plans Team, including Claims and Customer Service, to provide guidance on complex Authorizations, Referrals, Denials and Appeals. Integrates and coordinates services using continuous quality improvement initiatives to promote positive member outcomes.
Accurately counts nursing supply PAR levels and carts for all charge/non-charge items.
Consistently follows FIFO (First in First out) principles.
Apprises the Director/Manager and Coordinator daily of potential stock-out situations.
Key counts into the computer system and generates pick ticket.
Pulls supplies needed to replenish PARS as designated by the pick ticket.
Puts supplies onto shelves or carts in appropriate Nursing area.
Maintains cleanliness and organization of PAR levels.
Makes changes to PARS or quotas as directed by the Materials Manager/Director
Removes any extra supplies or overage that may be stored in unofficial PAR areas.
Follows thru on back ordered items to PARS and notifies department in need.
Maintains inventories for appropriate levels of supply in all supply areas.
Refills Supply Stations accurately and in a timely manner.
Responds to special or urgent supply request appropriately and in a timely manner.
Removes inactive users not accessing the system within 60 days from the system or upon notification from Unit Director, Human Resources or Information Services.
Inventory counts are done weekly for those items not filled since last count.
Runs quarterly, non-refill items, least 20 used items, tops 20 used items and monthly usage reports.
Monthly monitoring of NULL Transaction Trending reports to assist in providing timely feedback when corrective action is necessary.
Performs other duties as assigned or required.
Takes receipt of delivered goods, at the receiving area and signs delivery document presented by driver or designee.
Verifies number of boxes unloaded by shipper.
Assures all received packages are documented in the Daily Receipt log.
Unpacks, inspects and receives shipment, verifies all items received against packing slip and Purchase Order making receiving notations.
Attaches packing slips and freight documents to P.O.
Generates receiving documents from computer and attached to front of P.O. when backorders are present.
Delivers received goods to requesting department or Inventory shelves in a timely manner.
Gives priority to “RUSH” shipments or packages containing dry ice or labeled “Refrigerate upon arrival”.
Equipment deliveries are given to Bio-Med along with a copy of the purchase order, for inspection before delivery to requesting department.
Accurately separates stock and non-stock deliveries for proper handling
Obtains legible signature on purchase order on all non-stock goods.
Consistently inspects incoming deliveries for damage and contents are intact.
Assures accuracy of items received by verifying items received to packing slip provided.
Keys received items into the departmental information system.
Notifies the Buyer or Director or Manager of receipt of back order status, problems or discrepancies related to receiving or receipt of Capital equipment.
Assures that all stock items are placed in the appropriately assigned location.
Designates adequate shelf space for stock supplies based on usage classification and accessibility.
Ensures that all expired items are removed from the shelf in a timely manner and removed from the Materials management information system.
Processes all outgoing shipments in a timely manner.
Assures that all outgoing shipments are packaged appropriately.
Maintains accurate shipping logs.
Floor is routinely and adequately swept.
Trash is emptied routinely and adequately.
Excess boxes are broken down and removed.
Supplies are organized or placed neatly on shelves.
All other duties as assigned or required.
The Environmental Service Technician is responsible for maintaining a high level of cleanliness within the hospital and adjacent buildings, which may require traveling from one facility to another without assistance. Respond to and initiate communication by phone, handheld radios, pagers etc.
Responsible for the daily coordination and oversight to the Referral Technicians with regard to referral distribution and tracking. Assists Director of UR Dept. in providing oversight and monitoring productivity of UR Coordinators and Referral Technicians. Provides training to new staff on system and referral processes. Assists physician offices and vendors with problem resolution. Knowledgeable in policies, procedures and practices and keeps updated with regulations applicable to the department including applicable regulations pertinent to Self-Funded Plan.