Less than 5 years
Posted 57 days ago
**This position is on site + telephonic**
In this position you'll be serving as the communication link between patients and healthcare professionals. You'll identify the appropriate post-acute care (PAC) setting to make sure that the patient receives the best healthcare services and ensuring a smooth and efficient delivery of care. You'll also be working with the patient's family to offer support and information throughout the process.
Top Reasons to Love This Job:
1. Opportunity to make a difference to patients
2. Competitive salary offered
3. Full benefits package available
4. Opportunity to work with one of the best facilities in the state
Top "Must Have" Skills for This Job:
1. Registered Clinician is a requirement with preference for RN, PT, or OT credentials
2. Current active unrestricted clinical license required
3. 3-5 years of clinical experiencerequired
4. Experience working with geriatric population preferred
5. Bachelor's degreepreferred
6. Case Management experience within a Skilled Nursing Facility (SNF) is required
7. CCM is preferred
What you will be accountable for….
- Perform SNF assessments on patient using clinical skills and appropriate measurement tools such as LiveSafe, OPT, InterQual and CMS criteria upon admission to SNF and periodically through the patient's stay
- Review targets for LOS, target outcomes and discharge plans with the providers and family
- Completes all SNF concurrent reviews, updating Authorizations on a timely basis
- Collaborate effectively with the patient's health care team to establish an optimal discharge plan.
- The health care team includes physicians, referral coordinators, discharge planners, social workers, physical therapist, etc.
- Assure the patient is progressing toward discharge goals and assist to resolve barriers
- Participate in SNF Rounds weekly providing accurate and up to date information to the Sr. Manager or Medical Director
- Assure appropriate referrals are made to the Health Plan, High Risk Case Manager and/or community-based services
- Engages with patient, family or caregiver either telephonically or on-site weekly and as needed
- Attends the patient/family care conference
- Assess and monitor patient's continued appropriateness for SNF setting (as indicated) according to InterQual criteria or the OPT
- When delegated for utilization management review refer requests that cannot be approved for continued stay and are forwarded to licensed physicians for review and issuance of the NOMNC when appropriate
- Coordinate peer to peer reviews with Medical Directors
- Supports new delegated contract start up to ensure experienced staff work with new contract
- Manage assigned caseload in an efficient and effective manner utilizing time management skills
- Enter timely and accurate documentation into the CM Tool application
- Daily review of census and identification of barriers to manage independent workload and ability to assist others
- Review with the assigned Clinical Team Manager monthly dashboards, readmissionreports, quarterly and other reports as needed to assist with the identification of opportunities for improvement
- Adhere to organizational and departmental policies and procedures.
- Maintains confidentiality of all PHI information in compliance with HIPPA, federal and state regulations and laws