The Nurse Team Lead is responsible for daily operations (staffing and assignments) and directing the activities of the Clinical Resource Management department. Provides 24 hour accountability for planning, managing and evaluating department functions. Guides, supervises and elevates the quality of practice for utilization review within Children's National. Key areas of focus include use of nationally recognized criteria sets, status changes and concurrent denial management.
This state of the art, 60,000 square foot facility is the latest effort to ensure children and their families can easily and conveniently access Children's National specialists and primary care providers.
The outpatient clinics and surgery center provides families in Prince George's county greater access to the broad range of world-class care Children's National offers, including: cardiology, neurology, genetics, allergy, sports medicine and orthopedics, and rehabilitative medicine. Additionally, families will be able to more easily access infusion, transfusion, MRI, hematology and outpatient surgical services.
Children's National is the leading provider of pediatric care in the Washington, DC metro area. Our team of 8000+ employees provides world-class care in a warm and caring environment designed with kids in mind. Children's National is a Magnet® designated hospital and is consistently ranked among the best pediatric hospitals in America by U.S. News and World Report.Qualifications:Minimum EducationBachelor's Degree (Required)Master's Degree (Preferred)Minimum Work Experience5 years Nursing experience (Required)1 year Pediatric experience in a comparable setting (Required)1 year Demonstrated nursing leadership experience (Required)Required Skills/KnowledgeFamiliar with software such as Window's environment (Microsoft Office, Word, PowerPoint, Excel, Access).Excellent oral and written communication skills.Fluent in medical management criteria such as MCG and/or InterQual.Required Licenses and CertificationsRegistered Nurse in Maryland or Compact StateFunctional AccountabilitiesProfessional Practice/Research Facilitate the CMI practice group of Shared Nursing Leadership and support other initiatives.
Contribute to the sustainability and advancement of Magnet designation.
Ensure that utilization review for patient status (IP and Observation) is based on evidence of best practice.
Accountable for supporting/participating in the CRM and/or Division of Nursing's Performance Improvement processes.
Participate in community activities. Daily Operations Accountable for staffing and assigning coverage for all roles within CRM; engages with CMI Team Lead, Manager & Director to problem solve.
Responsible for 24/7 assessment and supervision of work flow for CMI's and support positions.
Supervise utilization review activities, interface with internal and external stakeholders to achieve appropriate level of care and optimize reimbursement; ensure compliance with CMS regulations.
Interact with payors and CRM leadership to improve the authorization process.
Engage in performance improvement activities to standardize and elevate practice. Communication Demonstrate advanced communication skills in dealing with staff and all members of the healthcare team.
Provide constructive, sensitive and timely feedback to staff concerning their performance in verbal and written form.
Effectively manage conflict and assist others to understand their behavior and their effect on the work environment.
Communicate and escalate issues as appropriate to the Manager and Director. Staff Education Facilitate learning opportunities for staff.
Participate in the education and training of Case Managers and other staff. Safety Speak up when team members appear to exhibit unsafe behavior or performance
Continuously validate and verify information needed for decision making or documentation
Stop in the face of uncertainty and takes time to resolve the situation
Demonstrate accurate, clear and timely verbal and written communication
Actively promote safety for patients, families, visitors and co-workers
Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance Organizational AccountabilitiesManagement and Leadership Skills Monitors Kronos reconciliation and ensures schedule and timecard accuracy
Responsible for all aspects of performance appraisal for designated staff
Participates in the hiring of staff by completing WFM paperwork, conducting interviews and making recommendations for hire
Assumes coverage of unit in absence of Manager & Director and makes decisions within authorized scope
Demonstrates initiatives and leadership through involvement in department based projects and committees
Establishes collaborative relationships and network across the organization to ensure effective outcomes
Represents CRM on organizational committees and initiatives Organizational Commitment/Identification Partner in the mission and upholds the core principles of the organization
Committed to diversity and recognizes value of cultural ethnic differences
Demonstrate personal and professional integrity
Maintain confidentiality at all times Customer Service Anticipate and responds to customer needs; follows up until needs are met Teamwork/Communication Demonstrate collaborative and respectful behavior
Partner with all team members to achieve goals
Receptive to others' ideas and opinions Performance Improvement/Problem-solving Contribute to a positive work environment
Demonstrate flexibility and willingness to change
Identify opportunities to improve clinical and administrative processes
Make appropriate decisions, using sound judgment Cost Management/Financial Responsibility Use resources efficiently
Search for less costly ways of doing things Organizational Accountabilities (Staff)Organizational Commitment/Identification
Teamwork/Communication Performance Improvement/Problem-solving Cost Management/Financial Responsibility Safety
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