Clinical Admissions Liason bei Oneida Health

Description

POSITION SUMMARY:   

The Clinical Admissions Liaison is a field-based position that acts as a liaison between prospective residents/patients, their families, various referral sources (hospitals, physicians, management care organizations, physician groups and other related agencies), and the facilities they represent. Responsible for the review, selection, assessment, and coordination of all Residents/Patients’ medical and related information necessary in determining appropriateness of placement/discharge planning, help meet census goals and obtain the necessary and required authorizations/approvals for placement. Provides prospective residents/patients and their families clear communication about services, care plans, and facility amenities. It is a field-based position. This requires travel to various referral sources as needed or directed. Responsible to strengthen current and build new ties to the community, enhance relationships with hospitals, senior living facilities, local senior centers, home care agencies, and physician’s offices. The Clinical Admissions Liaison works in conjunction with the facility’s Admissions team, Administrator, Director of Nursing, Director of Therapy/Rehabilitation, the Medical Director, Attending Physicians, and other department heads involved in admission, care, and discharge of resident. 

ESSENTIAL JOB RESPONSIBILITIES: During your shift, you may be required to perform some or all of the following: 

1. Adheres to all policies and procedures.
2. Acts as the facility liaison with all referral sources such as hospital discharge planners and related rehabilitation unit(s), physicians, health care agencies, health maintenance organizations, insurance companies, and any other source of referral. 
3. Verify insurance coverage and benefits for prospective residents, including Medicare, Medicaid, HMOs, and commercial plans, to determine eligibility and level of care coverage.
4. Coordinate pre-authorizations and obtain approvals from insurance providers and managed care organizations to ensure timely admissions.
5. Maintain a positive rapport with families and referral sources to foster trust and ongoing referrals.
6. Provide follow-up support post-admission to ensure satisfaction and resolve any concerns.
7. Ability to establish and maintain strong working relationships with hospital discharge planners, case managers, social workers, nurses, physicians, and other members of the healthcare professional community.
8. Works with the site Admissions team, facility Administrator, and/or facility staff to ensure consistent, effective, and appropriate admissions.
9. Collaborate with referral sources to gather necessary patient information (medical, financial, and social).
10. Conduct on-site evaluations/observations (e.g., in hospitals or patient homes) to assess suitability for nursing home placement.
11. Work with the nursing home’s admissions and clinical teams to review medical charts, insurance, and eligibility.
12. Facilitates admission decisions and ensures a positive experience for each resident and their family. This may include executing admission agreements and determining whether admission is short or long-term and establishes projected length of stay.
13. Maintain detailed records of referral interactions, patient inquiries, and outcomes.
14. Report on admissions trends, concerns, challenges, and successes to management.
15. Assesses/Recommend the need for customary and/or specialized placement. 
16. Serve as a liaison to patients/residents and their families, providing clear communication about services, care plans, and facility amenities.
17. Guide prospective residents and families through the admissions paperwork and insurance verification process.
18. Ensure all regulatory and compliance standards are met for new admissions.
19. Provides input/recommendations for admission criteria, clinical pathways, continued stays, CQI. 
20. Conducts the necessary reviews of any and all referrals, PRI’s and/or medical records for all aspects of medical care and rehabilitation services. 
21. Reviews related information with the patient/resident and/or responsible party and/or designated representative(s) and refers any specific matter to the appropriate department head.
22. May assist with execution of any marketing plans as directed to achieve maximum occupancy goals as needed including but not limited to outreach plans to promote new patients, new projects, and attend special events that serve community relations.
23. May assist in the collection of necessary documentation for admissions.
24. Meet with prospective residents and families to provide information and may conduct tours as needed.
25. Provide inhouse facility coverage on occasion as needed.
26. Assist in determining Medicare coverage and anticipated length of coverage prior to admission. 
27. Participates in determining the time frames of treatment goals as required by the approving pay and/or condition. 
28. Maintains the required daily, weekly, monthly and by request reports and documentation of all activity relating to the final determination and approval for admission/placement. 
29. Maintains relationships with managed care organizations with whom the facility has contractual relationship(s), and those who are seeking such a relationship as well as any other which the facility deems necessary. 
30. Ensure all regulatory and compliance standards are met for new admissions.
31. Participates in any required QA audits. 
32. Reviews financial application and assists families with completion of same. 
33. Other duties as assigned; additional hours may be required. 
34. Ensures the safety of all residents in accordance with facility policy and procedure.   
35. Monitors staff compliance with safety procedures as indicated below: 
    1. Maintains a clean, safe environment for residents and staff. 
    2. Adheres to fire plan, disaster plan and other safety plans established. 
36. Utilizes protective equipment, ie: safety goggles, as indicated per facility policy and protocol and Safety Data Sheets. 

Qualifications

CORE QUALIFICATIONS

Education & Licensure:

• Associate’s degree or completion of a two-year college program.
• Current, active license issued by the New York State (NYS) Education Department in one of the following professions:
  1. Physical Therapist (PT)
  2. Physical Therapy Assistant (PTA)
  3. Occupational Therapist (OT)
  4. Occupational Therapy Assistant (OTA/COTA)
  5. Registered Nurse (RN)
  6. Licensed Practical Nurse (LPN)
• Must be in good standing, meaning the license is active, unrestricted, and not subject to suspension, revocation, or disciplinary action.

Work Experience: 

1. 1. At least (3) years’ experience in areas such as rehabilitation, sub-acute units(s) or an acute care hospital.  
   2. Experience in managed care, preferred.
   3. Experience in marketing and/or public relations, preferred or sales/marketing background in a healthcare capacity.

Job Knowledge/Requirements: 

1. 1. Excellent clinical assessment/observation skills with a proven ability to relate to all levels of professionals, along with the ability to manage a fast-paced often intense daily routine with multiple priorities and time frames. 
   2. Self-motivated and driven can-do attitude.
   3. Upbeat and outgoing personality, with approachable nature.
   4. Valid Driver’s License and reliable transportation (mileage reimbursement)
   5. Strong Medical Terminology knowledge.
   6. Polished and professional appearance.
   7. Working knowledge and general understanding of insurances and sub-acute guidelines.
   8. Familiarity with the admissions process at a sub-acute rehabilitation facility.
   9. Excellent organization skills, time management skills, and attention to detail.
   10. Ability to work well under pressure and be flexible. 
   11. Exemplary customer service and communication skills. 
   12. A strong ability to build relationships with external referral sources.
   13. Competent computer skills with knowledge and understanding of Microsoft Word/Excel. 
   14. Willingness to travel to various referral sources, within the Middle and Lower Hudson Valley Region. Predominantly within Dutchess, Putnam, and Westchester Counties up to 100% of the time.