CareCentrix

  • Nurse Liaison - Post Acute Care (Remote- Rochester, NY)

    Job Locations US-NY-New York
    Job ID
    2018-6495
    Category
    Clinical / Post Acute Care
  • Overview

    Do you want to make a difference and help patients heal and age at home? As the Nurse Liaison you will be responsible for an assigned caseload at acute and post-acute care facilities. You will conduct in person, on site initial face to face outreach with patients to introduce the Post Acute program, gather patient demographics and collaborate with hospital clinicians, patient and family to develop a discharge path of care. You will coordinate post-acute care services for the patient and collaborate with Post Acute homecare agencies on post-acute care plan of care, authorizing services as medically necessary.

     

    Post-Acute Care (PAC) Program is an end-to-end post-acute offering that manages up to 90-day episodes of care, beginning prior to the patient's discharge from the hospital, or for elective surgical cases, outreach begins prior to hospitalization. The program optimizes our home-based network, identifies the likely best site-of-care for the patient, manages length of stay (LOS) if a Skilled Nursing Facility (SNF) is appropriate, and reduces hospital readmissions. Our program also coordinates all of the services required for a patient to transition to their home faster and safer, via our network of home health, durable medical equipment and home infusion providers, all of whom are supported by our CareCentrix care coordination team.

    Responsibilities

    • Manages the transition of assigned Post Acute patients from acute care setting to the skilled nursing facility and/or home setting utilizing face to face and/or telephonic outreach to accomplish the goals of the Post Acute Program. Care coordination and facilitation with hospital discharge planners, case managers and hospitalist to obtain Post Acute orders for engagement.In partnership with the UM team, authorize admission and continued stay at Skilled Nursing Facilities and Home Health care using approved medical care guidelines and collaboration with physicians and professionals within the healthcare setting. 
    • Engages the patient/caregiver using tools such as standard assessments, patient care plans, and documents all interactions in the Homebridge care coordination platform.
    • Communicate patient plan of care and discharge status with the Primary Care Physician and/or Specialist.
    • Facilitates obtaining appropriate home health physician orders for the home care services when needed.
    • Acts as a clinical resource for unlicensed Post Acute Care Coordinators, providing clinical expertise and helping to clarify referral source directives. Receives/responds to requests from unlicensed staff regarding scripted clinical questions and issues.
    • Contacts referral sources to advise them of referral status.
    • Participates in performance, operational and quality improvement activities and ensures the collection of data for improvement analysis and prepares reports as requested.
    • Communicates customer service/provider issues to supervisor for logging and resolution.
    • Assists team in implementing and maintaining standardized operational processes to ensure compliance to company policies, legal requirements and regulatory mandates.
    • Participates in implementing / maintaining operational processes to ensure compliance to company policies, legal requirements and regulatory mandates.
    • Willing to travel to acute and post-acute care facilities within the Candidates local assigned geographic area 25% to 50%.

    Qualifications

    • Current and unrestricted license for the market (state) of practice as a Registered Nurse. 
    • Expertise in Utilization Management and knowledge of URAC/NCQA standards. Broad knowledge of health care delivery/managed care regulations, contract terms/stipulations, prior utilization management/case management experience, and governmental home health agency regulations required. 
    • Excellent negotiation, communication, problem solving and decision making skills also required.
    • Works independently, utilizing sound clinical judgment and critical thinking skills under minimal supervision.
    • Must have a strong commitment to quality and standards.

     

    CareCentrix maintains a drug-free workplace in accordance with Florida's Drug Free Workplace Law

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