Job Description

SUMMARY OF JOB RESPONSIBILITIES

• 1. Receives referrals, via telephone, FAX or in person; processes them in accordance with agency policy, secures physician orders, coordinates all necessary disciplines and maintains an accurate record of all referrals. Collects at time of referral.
• 2. Collects all data required by policy and procedure at time of referral, verifies insurance information and verifies home care coverage.
• 3. Follow admission through completion with full and complete documentation.
• 4. Communicate with co-workers and coordinate follow up needed to obtain the necessary documentation for a complete patient record.
• 5. Review clinical documentation to determine reason for home health to communicate with field staff and coordinate documentation.
• 6. Communicate with patients for confirmation of admission, primary care provider information, and verify patient location and contact info.
• 7. Receives authorization for Home Health Services.
• 8. Evaluates referral against customer needs, determines appropriate services for the patient. Establishes individual patient’s multi-disciplinary needs.
• 9. Verifies funding source for new patient referrals and coordinates payment issues with appropriate affected persons.
• 10. Negotiates rates and payments with various funding sources and customers as approved by the President.
• 11. Obtains pre-certification information from case management firms for patient care. Tracks all insurance patient certification dates for services.
• 12. Provides or makes provision for patient care in accordance with Nurse Practice Act and other professional practice acts, physician orders and Clinical Pathways. Communicates necessary information to other members of the health care team within 24 hours.
• 13. Acts as a resource for questions regarding home care services and appropriateness for referrals. Communicates appropriately and is able to understand customer/patient/employee needs, satisfactorily answers questions and maintains liaison and rapport with patients, caregivers and employees.
• 14. Collaborates and coordinates with other home care professionals and paraprofessionals. Identifies and discusses special patient needs with the appropriate supervisor to ensure that staff abilities match patient needs for therapeutic care.
• 15. Maintains current resource information regarding available community services to meet actual and/or potential patient needs and when appropriate, coordinates referrals and/or services with these resources. Assists with resolving financial problems related to obtaining home medical services.
• 16. Maintains patient, staff and agency confidentiality.
• 17. Demonstrates high degree of commitment to quality customer service provision.
• 18. Exhibits good interpersonal relationship skills, written, telephone and verbal communication skills.
• 19. Participates in organizational, administrative and management committees as designated.
• 20. Problem-solves with all departments as needs arise, including patient service and inter- departmental issues.
• 21. Exhibits good interpersonal relationships, including written, telephone & verbal communications skills.
• 22. Completes other duties as requested or assigned. 279

QUALIFICATIONS

• 1. Graduate of an accredited school of nursing; registered as a Registered Nurse / Licensed Practical Nurse in the State of Oklahoma.
• 2. Three to five years' experience in home care preferred, with two years in case management or intake, highly desirable.
• 3. Knowledgeable of Medicare, Medicaid, private insurance and DME regulations, as well as JCAHO, DHS, local, state and federal regulations.
• 4. Broad knowledge of principles of nursing and rehab home health and their application.
• 5. Excellent verbal and written communications skills including excellent telephone communication and listening skills.
• 6. Ability to seek and obtain patient information.
• 7. Ability to multi-task and manage multiple patient cases.
• 8. Adept at dealing with challenging personalities, managing stress and accommodating multiple demands for commitment of time, energy and resources.
• 9. Knowledge of Clinical Pathways and outcomes management. Responsible for financial case management.
• 10. Time management skills, ability to meet deadlines and to work independently, exercising independent judgment and critical thinking.
• 11. Servant attitude toward servicing clients and internal customers from all departments.
• 12. Ability to meet the physical demands of sitting for long periods with occasional standing, walking, bending, lifting and transfers.
• 13. Licensed driver with automobile that is in good working order and insured in accordance with the Agency requirements; have proof of insurance.
• 14. Computer literate with working knowledge of Windows/MS Office applications. Able to type at least 25 words per minute.
• 15. Attendance: Monday through Friday, office hours.