Process appropriate infusion therapy referrals by checking benefit information and acquiring initial authorization as needed to begin patient service or to seek an alternate plan when services are not covered. Communicate effectively with contacts to assure appropriate admission to Fairview Home Infusion services.
Initiate calls to receive prior authorization information for services prior to service delivery
Takes initiatives to problem solve all questionable referrals to assure appropriate infusion therapy admissions and identify payer sources
Follow up on pending unresolved coverage issues. Document and communicate to appropriate providers and internal departments accurate clinical information, benefit/authorization, and reauthorization information on current or potential patients. Utilize computer (CPR +/Pathways) to enter and maintain accurate/real time physician orders, patient benefit information and to effectively communicate with referral staff, liaisons, social workers, physicians, clinics, HCH teams or departments, case managers, staffers, billing/benefit staff and all others needing to make service-related decisions.
Coordinate the delivery of nursing services for infusion therapy when the patient resides outside the Twin City metropolitan area.
Responsible for identifying and contracting with appropriate nursing agencies that will deliver care to patients that receives infusion therapy services. Responsibilities include coordinating discharge planning, educating patients/caregivers, educating appropriate home care agencies, serving as a resource to referral sources and providing necessary follow-up to involved parties. Utilizes clinical expertise and advanced nursing skills in providing quality infusion therapy services to patients.
Clinical resource for all nursing issues related to patients in service at FHI.
Assure fast, easy access to FHI services as an expert infusion therapy resource for referral sources, nursing agencies, patients and FHI staff.
Identify and contract with nursing agencies outside the metropolitan area that will provide quality nursing care to patients who receive infusion therapy services from Fairview Home Infusion.
Provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.
Minimum Education: Graduate of an approved school of professional registered nursing
Minimum License/Certification/Registration: Current RN licensure in state of Minnesota
Preferred License/Certification/Registration: BSN preferred. OCN or CRNI preferred.
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership ...with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.