Home Health Clinical Liaison - Brevard County

Job Summary

Responsible for creating an exceptional customer experience for Central Pyramid patients transitioning from the hospital to the home health setting. Ensures a safe transition by facilitating effective communication between the patient’s healthcare team and the Home Health agency while ensuring patient and caregiver needs are addressed. Builds and maintains positive relationships with hospital teams, healthcare providers, and other key stakeholders. Adheres to and promotes the mission of Central Pyramid.

Essential Functions

• Provides individualized service delivery throughout the transition process, ensuring the patient, family, and caregiver needs are met.
• Creates and maintains a positive relationship with the hospital Case Management team.
• After a referral from the hospital CM, meets with patients to discuss the home health benefit, answer questions, and develop a preliminary plan of care.
• Manages the referral process from the hospital through home health agency acceptance including support of electronic platform referrals. Ensures the patient meets CMS criteria for home health services.
• Ensures required documentation is sent with the referral to ensure a billable episode of care. Ensures the Face to Face documentation supports the reason for home health services.
• Serves as a resource to the hospital regarding home health services.
• Provides and develops home health educational in-services to hospital teams as requested.
• Demonstrates critical thinking skills and the ability to problem-solve. Reaches out to home health agency leadership when needed.
• Develops effective rapport with physicians, hospital colleagues, discharge planners, and other key contacts and regularly visits them.
• Leads new initiatives within assigned area and is responsible for the successful implementation of programs.
• Other duties as assigned.

This job description represents an overview of the responsibilities for the above-referenced position. It is

not intended to represent a comprehensive list of responsibilities. Colleagues should perform all duties as

assignedby his/her supervisor.

Education and Experience

Minimum two years of experience in home health required.

Experience working in transitional care or case management preferred.

Certifications, Licenses, and Other Special Requirements

Clinical license required, LPN license preferred.

Management/DecisionMaking

Uses limited independent judgment to make decisions based on precedents and established guidelines.

Solves problems using standard procedures and precedents.

Knows when to refer issues to supervisor and when to handle them personally.

Other Knowledge and Skills

• Maintains up-to-date knowledge of the CMS Skilled Home Health benefit.

• Proficient in Microsoft Office including Outlook.

• Able to work holidays and weekends to meet agency needs.

• Maintains the highest standards of ethical, professional, and clinical