Job Description
Newport News, Virginia
Overview
Performs coordination of patient services to provide a seamless transition from acute and long term care settings to Home Care. Elements required for above include data collection and clinical review of all referrals; determination of referral acceptance based on established criteria and collaboration with Home Care team members; attaining and remaining knowledgeable and current related to Medicare/Insurance reimbursement and basic coverage criteria, and of service lines and products; and conferencing with patients, families, discharge planners, physicians, medical staff and others to coordinate and facilitate transition and services. Works closely with facility care management/discharge planners to identify potential referrals for Home Care Services. Provides exceptional customer service and serves as the 'face' of RHCD to all contacts by telephone, in person and via electronic media.
What You Will Do
- Performs coordination of patient services to provide a seamless transition from acute and long term care settings to Home Care. Performs clinical review of data collected, determining appropriateness and acceptance of referrals based on established criteria, coordinates services and dissemination of information. Facilitates transfer of referral to other agency for declined referrals. Performs any follow up and continues communication with all parties until referral is complete and/or services are provided or cancelled.
- Uses clinical knowledge to collect complete and appropriate data for referrals. Serves as an information resource for all applicable services including contact information, coverage criteria, availability of services and alternatives to applicable services when appropriate.
- Responsible for data maintenance and integrity, entering and retrieving data from various computer systems and recording on specified forms.
- Collaborates with care management team/discharge planners to identify potential referrals for RHCD services.
- Builds and maintains a comprehensive knowledge base of Medicare/Insurance information and regulations, RHCD products and services, and community resources.
- Performs patient interviews and/or family conferences to inform of ordered services, verify demographics, answer any questions, discuss insurance coverage as appropriate, discuss any special circumstances or barriers to a safe transition or care at home as appropriate.
Qualifications
Education
- Program Graduate, Licensed Practical Nurse (Required)
- Bachelors Degree, Nursing (Preferred)
Experience
- 1 year Nursing experience (Required)
- Home Health, Home Infusion, Hospice or Discharge Planning (Preferred)
Licenses and Certifications
- Licensed Practical Nurse (LPN) - Virginia Department of Health Professions (VDHP) (Required)
- CPR/BLS Certification - American Heart Association/American Red Cross/American Safety and Health Institute (AHA/ARC) within 30 Days(Required)
- Valid Drivers License Required
To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.