Job Description
This role is responsible for identifying and evaluating potential LTACH candidates during their acute hospital stay, ensuring they meet the clinical and regulatory criteria for LTACH admission. The Clinical Liaison coordinates closely with physicians, case managers, and hospital staff to facilitate appropriate transitions of care. This position also includes a strong emphasis on insurance verification and payor source evaluation to ensure authorization and reimbursement eligibility.
Responsibilities
Essential Duties and Responsibilities:
Patient Evaluation & Tracking
Required Qualifications:
The noise level in the work environment is usually moderate.
The setting for this role will include office and healthcare settings. Exposure to controlled temperature environments, both hot and cold, is to be expected.
Workplace Exposure
The normal work routine involves no exposure to blood, body fluids or tissues. Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.
Physical Demands
While performing the duties of this job, the employee is regularly required to communicate with others. The employee is frequently required to stand, walk, sit, demonstrate hand and finger dexterity in the course of their work, handle or feel, and reach with hands and arms. The employee is occasionally required to climb, balance, stoop, kneel, crouch or crawl.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties and responsibilities.
The Expected Physical Workload Is Expected To Be
Sedentary Work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
This role is responsible for identifying and evaluating potential LTACH candidates during their acute hospital stay, ensuring they meet the clinical and regulatory criteria for LTACH admission. The Clinical Liaison coordinates closely with physicians, case managers, and hospital staff to facilitate appropriate transitions of care. This position also includes a strong emphasis on insurance verification and payor source evaluation to ensure authorization and reimbursement eligibility.
Responsibilities
Essential Duties and Responsibilities:
Patient Evaluation & Tracking
- Conduct clinical assessments of hospitalized patients to determine medical appropriateness for LTACH admission.
- Monitor patients during their acute care stay for changes in condition that may affect LTACH eligibility.
- Maintain up-to-date tracking and documentation of potential referrals.
- Collaborate with acute hospital case managers, discharge planners, physicians, and families to advocate for transition to LTACH when clinically appropriate.
- Serve as the primary liaison between the acute care facility and the LTACH to ensure timely and appropriate handoffs.
- Attend interdisciplinary rounds and care conferences as needed.
- Ensure all patients meet CMS and internal medical necessity criteria for LTACH admission.
- Complete and document clinical evaluations in accordance with hospital and regulatory standards.
- Review patient insurance and payor source information to determine coverage and authorization requirements for LTACH admission.
- Work closely with internal financial counselors and admissions teams to ensure a smooth and financially viable transition of care.
- Build and maintain positive relationships with referral sources, acute care hospitals, and physician partners.
- Represent the LTACH at community and hospital events, as appropriate
- Performs other duties as assigned.
Required Qualifications:
- Current active VA RN License
- Graduate of and accredited School of Nursing
- Basic Life Support (BLS)
- 2 Years RN experience
- Prior experience in healthcare admissions, patient intake, or a similar role preferred.
- Travel may be required up to 50% of the time to visit acute care hospitals, review potential admissions, and discuss the plan of care with case management and providers.
The noise level in the work environment is usually moderate.
The setting for this role will include office and healthcare settings. Exposure to controlled temperature environments, both hot and cold, is to be expected.
Workplace Exposure
The normal work routine involves no exposure to blood, body fluids or tissues. Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.
Physical Demands
While performing the duties of this job, the employee is regularly required to communicate with others. The employee is frequently required to stand, walk, sit, demonstrate hand and finger dexterity in the course of their work, handle or feel, and reach with hands and arms. The employee is occasionally required to climb, balance, stoop, kneel, crouch or crawl.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties and responsibilities.
The Expected Physical Workload Is Expected To Be
Sedentary Work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
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