The
Director of Patient Outcomes position directs the completion of the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS). Provides clinical support in completion of data contained in prospective payment system (PPS) and functional outcome measure (FOM) instruments for each patient to ensure accuracy in the scoring of functional status and reflection of the patient's care needs. May direct Case Management Department, as needed. This position must integrate company values into daily practice.
Essential Functions:- Collects data and monitors Quality Indicators and the Care Tools.
- Maintains FOM credentialing and staff education.
- Attends Operations/Admissions meetings and reviews patients for tiers and compliance.
- Attends team conferences and assists Health Information Management (HIM) with accuracy of coded tiers with queries.
- Reviews physician documentation for medical necessity and function changes.
- Manages all FOM functions, ensuring accuracy (rounds, education, certification, etc.)
- Tracks Compliancy (CMS13) and assists in attainment of required documentation from clinical liaison's and physicians to support.
- Reports and assists in management of patient outcomes.Attends Utilization Reviews and reports as necessary.
- Manages Medical Necessity Denials.
- May lead and direct the case management department as assigned, to include: management of staffing needs, and caseloads; education, direction, and mentorship of the Case Management Team, and reporting and assistance in the management of patient outcomes.
- Provides an environment conducive to safety for patients, visitors, and staff. Assesses the risks for safety and implements appropriate precautions. Complies with appropriate and approved safety and Infection Prevention standards.
- Completes required trainings, as assigned.
- Performs other duties as assigned to support overall effectiveness of the organization.
Minimum Job RequirementsMinimum Education & Experience:
- Two years recent experience in acute care setting preferred.
Required Licenses, Certifications, and/or Documentation:
- Clinical license required (PT, OT, SLP, or RN).
- Must maintain acceptable driving record, current driver's license, and insurability.
Required Knowledge, Skills, and Abilities:
- Demonstrable knowledge in all aspects of clinical care of the rehab patient
- Demonstrates general computer skills including data entry, word processing, email, and records management.
- Demonstrates critical thinking skills.
- Effective organizational and time management skills.
- Effective written and verbal communication skills.
- Ability to prioritize, meet deadlines, and complete complex tasks.
- Ability to maintain quality, safety, and/or infection prevention standards.
- Ability to work independently.
- Ability to maintain proper levels of confidentiality.
- Ability to work closely and professionally with others at all levels of the organization.
Physical Requirements Over the Course of a Shift:- A significant amount of sitting, often for prolonged periods of time.
- Lifting/exerting of up to 50 lbs.
- Possible exposure to bodily fluids.
- Visual acuity required for patient assessment and documentation of care.
- Acute hearing required for accurate patient assessment.
- Sufficient manual dexterity to operate equipment and computer keyboard.
