Nurse Liaison - CareCentrix : Job Details

Are you an experienced Registered Nurse with a passion for shaping the future of healthcare?

As a Nurse Liaison you will be an expert in resource management, a master of utilization review and a compassionate partner for patients and their support network. You will be responsible for an assigned caseload at acute and post-acute care facilities. You will conduct in person, on site, face to face outreach, with patients to introduce the Post-Acute program. You will gather patient demographics and collaborate with hospital clinicians, patients and their family to develop a discharge plan of care and 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.

The Post-Acute Care program helps to reduce hospital readmissions of patients and has aspects of education and coaching to assist patient's transition home after a hospital stay. The program works directly with patient treatment plans, facilitates in home health care services to accomplish the treatment plan, patient goals and patient education/coaching along with adherence/compliance monitoring.

Responsibilities

In this Job, you will:

• Determine the optimal site of care for patients post hospital discharge in collaboration with hospital discharge planners, case managers, hospitalist and CareCentrix Medical Directors.
• Manage and influence the transition of assigned Post-Acute Care patients from acute care setting to the SNF, IRF, LTACH or home setting utilizing face to face and/or telephonic outreach.
• Help coordinate the orders for home health and other post-acute care services.
• Contact referral sources to advise and relay updates to the appropriate individuals.
• Partner closely with the PAC Medical Director in reviewing discharge plans and length of stay status to ensure optimal outcomes.
• Communicate customer service/provider issues to supervisor for logging and resolution.
• Engage and coach patients/caregivers on progress toward goals, safe transitions to the next site of care and readmission avoidance resources.
• Document all interactions, problems, goals and interventions to meet documentation guidelines.
• Work closely with the home health agencies and post-acute providers to ensure a smooth transition to home or facility with appropriate services.
• Act as a clinical resource for unlicensed staff, to provide clinical expertise and help with referral source directives, clinical questions and issues.
• Communicate facility or market level trends related to census, diagnosis, barriers to discharge and social determinants of health factors for your market population.
• Participate and contribute to ongoing quality assessment/improvement activities, performance, data collection, analysis, operational process activities and prepares reports.
• Assist team in implementing and maintaining standardized operational processes to ensure compliance to company policies, legal requirements and regulatory mandates.
• Participate in implementing / maintaining operational processes to ensure compliance to company policies, legal requirements and regulatory mandates.
• Participate in special projects and perform other duties as assigned.

This is the job for you if:

• You are willing to travel 75% of the time to hospitals, SNF, IRF, LTACH and physician offices within assigned geography locations.
• You can work independently, utilizing sound clinical judgment and critical thinking skills under minimal supervision.
• You have a strong commitment to quality and standards.

Qualifications

You should get in touch if: (Education, skills and experience)

• You hold a current and unrestricted Registered Nurse license. (Required)
• You have a minimum of five years RN experience (Required- preferably with a geriatric population).
• You are an expert in Utilization Management and have knowledge of URAC & NCQA standards.
• You have a 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)
• You possess negotiation, communication, influencing, problem solving and decision-making skills. (Required.)
• You possess a high-level clinical knowledge, communication, customer service and problem-solving skills, as well as the ability to effectively interact with all levels of management and a highly diverse clientele.
• You have excellent communication, organizational, interpersonal skills and are able to effectively manage and prioritize tasks.
• You are willing to travel 75% of the time to hospitals, SNF, IRF, LTACH and physician offices within assigned geography locations.

What we offer:

• Full range of benefits including Health, Dental and Vision with HSA Employer Contributions and Dependent Care FSA Employer Match
• Bonus Incentives, Generous PTO, 401K Savings Plan, Paid Parental Leave, free on-demand Virtual Fitness Training and more
• Advancement Opportunities, professional skills training, and tuition /exam reimbursement
• PayActiv - access earned income in between pay checks
• Walgreens Discount - receive up to 25% off eligible items
• Great culture with a sense of community

CareCentrix maintains a drug-free workplace