Clinical Liaison - Inpat Rehab at Parkview Health

Summary

Responsible for establishing relationships with case coordinators, physicians, payors, and other referral sources. Ensures appropriate patient placement through clinical screenings and assessments in collaboration with both hospital Case Coordination and the Inpatient Rehabilitation Medical Director. Works closely with hospital Case Coordinators.

Essential Functions and Responsibilities:

Develops and establishes effective working relationships with all referral sources both internal and external. Facilitates professional communication with all members of acute care team, community organizations, and insurance companies. Coaches, encourages, and monitors teamwork and represents a positive first impression of the inpatient rehabilitation unit.  Performs initial assessment on patients, reviews their medical records and determines whether they should be admitted for care and or followed for future potential admission. This requires decision-making for the appropriate level of care; may include admission/transfer reviews, utilization reviews.  Facilitates acute rehab admissions for those referrals that are appropriate for admission to the inpatient Rehab Unit. In collaboration with the acute care hospital staff and the rehab team, collects required patient information and completes all documentation that is required for admission.  Assesses acute care patients to identify needs, rehab potential, resources and care goals.  Participates in pre/post screening problem solving.  Conducts tours and greets families and other decision-makers.  Understands or facilitates pre-admission insurance authorization process.  Utilizes expert insurance authorization process knowledge to prepare for customized reviews of the medical record and required authorization process including initial approval and subsequent approvals. This may include prepping for the peer-to-peer reviews between the physician and insurance company.  In collaboration with the acute care hospital staff, completes pre-screen process required for admission to Rehab Unit and enters completed screen into CMS tool within 24 hours.  Collaborates with the referring hospital staff, inpatient staff and admitting physicians to determine an admission plan and admission date that is appropriate for the patient and the referring hospital.  Completes admission and post-acute care placement work unique to inpatient rehabilitation in place of the acute care case manager to assist with through put and appropriate level of care.  Demonstrates patient advocacy and sustains team focus and provides guidance in team decision-making.  Explains the types of care and expectations of services the rehabilitation facility offers to the patient and families.  Develops relationships with current and potential referral sources including insurance case managers and payer sources with education regarding rehabilitation.  Complies with federal, state, and local legal and certification requirements by studying requirements; advising management on need actions. This includes compliance with all health care regulations.  Is aware of the compliance rule @ 60% and reporting any issues to management and PM&R Medical Director.

Education

Registered Nurse: Associate of Science in Nursing (ASN); Bachelor of Science in Nursing (BSN) preferred.

OR

Speech-Language Pathologist: Must hold at a minimum a Master's Degree in Speech-Language Pathology from a school accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA).

OR

Physical Therapist: Must be a graduate of an accredited school of physical therapy, with a physical therapy degree as follows: Minimum of a Bachelor's degree, if graduated prior 1/1/2016; Doctorate of Physical Therapy required, if graduated after 1/1/2016; International Candidates must be a graduate of an accredited school and possess a minimum of a Bachelor's degree in Physical Therapy. Doctorate of Physical Therapy degree preferred.

OR

Occupational Therapist: Must be a graduate of an accredited school of Occupational Therapy, with an Occupational Therapy degree as follows: Minimum of a Bachelor's degree if graduated before 1/1/2002; Master's degree required if graduated after 1/1/2002; International Candidates must be a graduate of an accredited school and possess a minimum of a Bachelor's degree in Occupational Therapy. A Master's degree is preferred.

Licensure/Certification

State licensure as Registered Nurse, Physical Therapist, Occupational Therapist or Speech Language Pathologist.

Addendums are required for 0153 Nurse Leader, 0249 Registry RN, 0252 Registered Nurse, 0235 Advanced Registered Nurse, and 0236 Expert Registered Nurse. To view addendums, go to the job description page on Parkview’s intranet.

Experience

Two years related experience working in a clinical healthcare setting or previous experience working in a clinical liaison role preferred.

Other Qualifications

Demonstrated competency with the preadmission process including assessments and relationship building in a rehabilitation setting or in another post-acute care setting preferred.  Demonstrated computer proficiency.  Must have good verbal and written communication skills. Must be able to demonstrate organizational skills and ability to plan, design, and develop education plans.