Job id-463174100
Essential Duties and Responsibilities:
- Provides utilization oversight and management of Medicare services through:
- Assists in the coordination of services for patients/clients discharge from the hospital into the home health program.
- Works primarily with all nursing units to identify and assess patient and family needs for continuity of care.
- As appropriate, collaborates with the hospital social services and discharge planning personnel with the coordination of home health services.
- Makes daily rounds to assess discharge planning needs of agency patients and documents discharge plan for all agency patients within 24-48 hours of admission to hospital’s discharge planning department.
- Assess appropriateness of referred patients/clients to the home health organization for home care.
- Coordinates home care needs with the agency in accordance with the physician’s plan of care at the hospital/nursing home discharge.
- Assures physicians orders are received for home care.
- Identifies, verifies and obtains authorization for home health services from insurance providers, as appropriate. Maintains needed documentation for such.
- Completes all necessary forms as required by referring sources as well as those required of agency admits.
- Determines patient eligibility criteria for hospice with guidance from agency leadership and/or medical director utilizing the Local Coverage Determinants.
- Uses professional skills to screen patient/family issues and concerns. Informs hospice team of medical and psychosocial needs based upon information gathered.
- Provides information regarding community resources, advance care planning, and legal requirements in order to facilitate the admission process.
- Adhere to all company policies and procedures
- Adherence to and compliance with information systems security is everyone’s responsibility. It is the responsibility of every computer user to: Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems.
Non-Essential Duties and Responsibilities:
- Perform other duties as assigned.
Minimum Qualifications:
Education/Licensing/Certification:
- Graduate of an accredited school of nursing. BSN preferred.
- Currently licensed as a registered nurse in the state of practice.
- Current Driver’s license
- Use of car and automobile insurance required
Experience:
- One or more years of experience in a homecare setting
Knowledge and Skills:
- Excellent computer skills
- Excellent interpersonal skills
- Excellent organizational skills
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