Physician Navigator - PRN | El Paso Rehab

Direct Marketing

• Identifies and targets new referral sources for PAM Health within assigned territory.
• Establishes and maintains strong relationships with referral sources in assigned territory through ongoing assessment and servicing of their rehabilitation needs.
• Performs in-person appointments to market PAM Health programs to designated referral sources within assigned territory and meet assigned objectives on a weekly basis.
• Communicates clearly, concisely and accurately.
• Maintains an excellent understanding of all inpatient/outpatient programs, including features and benefits of such programs throughout the system.
• Mets assigned objectives for weekly calls, joint marketing, professional tours and educational presentations.

Pre-Admission Assessment

• Maintains responsibility for patient referral until patient admits to PAM Health.
• Displays knowledge of both inpatient rehabilitation and long-term acute care (LTACH) admissions criteria for preassessment analysis.
• Captures on-site pre-admission assessments on potential patients unless geographically prohibitive or competitive time of admission will not allow.
• Reviews medical record of referred patient and identifies all aspects related to pre-certification financial coverage and admission criteria.
• Serves as a navigator to the Admissions office for insurance companies and provides clinical information to obtain pre-certification from payers.
• After reviewing medical record and interviewing patient/family, obtains facility admission information to support the admission process; makes a recommendation regarding acceptance and level of care, and communicates status of admission to referral source as directed by the admissions department.
• Orients patient and/or family to facility services, including length of stay.
• Communicates with facility Admissions department and facility CEO on a daily basis to optimize census management and case finding strategies.
• Follows up on all pending as well as medical denials in person to re-evaluate potential for admission.
• Conducts follow up with referral facilities to ensure satisfaction and service levels were met.

Documentation and Reporting

• Completes and submits weekly call reports in a timely manner.
• Sets up and maintains customer profiles (Physician, Case Manager, Employer, etc.) in Upshot and updates as needed.
• Contributes to ongoing market research by gathering information on the market and forwarding to management.
• Provides management with identified areas of need or activities that will enhance the marketing endeavors of the organization.
• Assists in the development of new programs and enhanced services through ongoing assessment of stakeholder needs of the market.
• Identifies new business/partner opportunities and communicates to management.
• Completes and submits time and expense reports and American Express receipts by second working day each month.

Managed Care Relationships

• Identifies opportunities for contracting with managed care companies and provider networks.
• Coordinates appointments with managed care companies and PAM Health Case Managers and/or Director of Managed Care as appropriate.

Customer Service

• Maintains the highest level of customer service via courtesy, compassion and positive communication.
• Promotes the mission and vision of PAM Health within the work environment and the community.
• Respects dignity and confidentiality by adherence to all applicable policies and procedures.

Health and Safety

• Works in a manner that promotes safety; wears clothing appropriate to the performance of the job.
• Participates in OSHA required training.
• Follows universal precautions as appropriate for position; complies with Employee Health requirements for continued employment.
• Reports unsafe practices to management.
• Knows own role in case of an emergency.