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Job SummaryThe Telephonic Care Coordinator plays an integral role in optimizing patient’s recovery journeys. The position completes weekly functional assessments and engages the PAC inter-disciplinary care team providing them with the proprietary nH Outcome tool to align expectations for discharge planning. The role engages the patient and family to share information and facilitate informed decisions. By serving as the link between patients and the appropriate health care personnel, the Telephonic Care Coordinator is responsible for ensuring efficient, smooth, and prompt transitions of care. Responsibilities
Perform Skilled Nursing Facility (SNF) assessments on patients using clinical skills and appropriate measurement tools, such as nH Predict, nH Outcome, InterQual and CMS criteria, upon admission to SNF and periodically through the patient stays.
Review targets for Length of Stay (LOS), target outcomes, and discharge plans with providers and families.
Complete all SNF concurrent reviews, updating authorizations on a timely basis.
Collaborate effectively with the patients’ health care teams to establish an optimal discharge. The health care team includes physicians, referral coordinators, discharge planners, social workers, physical therapists, etc.
Assure patients progress toward discharge goals and assist in resolving barriers.
Participate weekly in SNF Rounds providing accurate and up to date information to the naviHealth Sr. Manager or Medical Director.
Assure appropriate referrals are made to the Health Plan, High Risk Case Manager, and/or community-based services.
Engage with patients, families, or caregivers telephonically as needed.
Attend patient/family care conferences.
Assess and monitor patients’ continued appropriateness for SNF setting (as indicated) according to InterQual criteria or the nH Outcome.
When naviHealth is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forward to licensed physicians for review and issuance of the NOMNC when appropriate.
Coordinate peer to peer reviews with naviHealth Medical Directors.
Support new delegated contract start-up to ensure experienced staff work with new contracts.
Manage assigned caseload in an efficiently and effectively utilizing time management skills.
Enter timely and accurate documentation into the CM Tool application.
Daily review of census and identification of barriers to managing independent workload and ability to assist others.
Review monthly dashboards, readmission reports, quarterly, and other reports with the assigned Clinical Team Manager, as needed, to assist with the identification of opportunities for improvement.
Adhere to organizational and departmental policies and procedures.
Maintain confidentiality of all PHI information in compliance with HIPPA, federal and state regulations, and laws.
Perform other duties and responsibilities as required, assigned, or requested.
Qualifications
Active, unrestricted registered clinical license required – Registered Nurse, Physical Therapist, Occupational Therapist, or Speech Therapist
3 - 5 years of clinical experience required
At least 2 years of Case Management experience preferred
Patient education background, rehabilitation, and/or home health nursing experience a plus
Experience working with geriatric population preferred
Exceptional verbal and written interpersonal and communication skills
Strong problem solving, conflict resolution, and negotiating skills
Proficient with Microsoft Office applications including Word, Excel and PowerPoint
Independent problem identification/resolution and decision-making skills
Detail-oriented
Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously
Team player
Work Conditions and Physical Requirements
Ability to establish a home office workspace
Ability to manipulate laptop computer (or similar hardware) between office and site settings
Ability to view screen and enter data into a laptop computer (or similar hardware) within a standard time period
Ability to communicate with clients and team members including use of cellular phone or comparable communication device
Ability to sit for an extend time periods (1-2 hours)
Travel requirements
Ability to travel, including overnight stay(s), on a quarterly basis to support market goals and objectives as needed, such as provider network meetings and staff education
Must attend 2 weeks of onsite training at Corporate Office in Brentwood, TN
About naviHealthBeing a pioneer in post-acute management and care transitions with 19 years of experience, naviHealth is uniquely positioned to manage patients, improve clinical and financial outcomes, and share risk with payors and providers. We provide clinical service support alongside proprietary technology and advisory solutions that empower health systems, health plans and post-acute providers to navigate care episodes across the continuum, with the goal of reducing waste and improving patient outcomes.Our ValuesWe care about the people we serve.We care about each other.We care about our communities.We embrace innovation.We like simple.The above statements are intended to describe the general nature and level of work performed by colleagues assigned to this job. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications. naviHealth reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.naviHealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other protected status under applicable laws and will not be discriminated against on the basis of disability.Requisition ID: 2020-3273 Location Type: Field / Office / Virtual: Field (in Market)
Vacancy expired!