Rehab Liaison / Care Coordinator

About the role

Evaluates rehab referrals for admission based on CMS' IRF Guidelines.

Responsibilities

• Completes pre-admission assessment on all patients admitted to the DCH Rehabilitation Pavilion.
• Completes insurance pre-certification on all patients being admitted with commercial insurance.
• Insures proper utilization of resources by recommending proper level of post-acute care on all referred patients.
• Functions in rehab team leadership role by identifying patients needs to justify rehab admission.
• Captures and coordinates flow of information between patient, families, rehab team, physicians, and payers.
• Screens referred patients, summarizing acute care hospital course, including pertinent diagnostics, procedures, lab results, imaging studies, and therapy status.
• Uses clinical judgment and rehab physician input to guide acute care team on medical, nursing, and functional interventions needed for patient to qualify for rehab admission.
• Screens referred patients, comprehensively assessing patient’s prior functional status, home situation, rehabilitation needs, ability to participate, expectations for functional improvement, and discharge plan.
• Completes a comprehensive pre-admission assessment form, justifying rehab admissions.
• Pre-certifies all patients with commercial insurance by providing a detailed case summary along with the comprehensive pre-admission assessment to the insurance case manager.
• Makes every effort to meet admission/census goals for the DCH Rehabilitation Pavilion.
• Documents patient’s rehab acceptance/denial and reasons in medical record.
• Clearly documents reasons for rehab admission on pre-admission assessment form to justify admission and begin team treatment planning process.
• Provides guidance to acute care case managers to ensure patients are being referred and accepted at the appropriate post-acute level of care.
• Rotates weekend coverage with other Admissions/Care Coordinators, as assigned.
• Assists in patient education activities.
• Conducts in-service classes in hospital and community when requested.
• Coordinates responsibilities with other Admissions/Care Coordinators.
• Maintains required records and reports.
• Maintains personal automobile liability insurance, and remains insurable to the standards that are established by DCH’s insurer as they may exist at any time.

Qualifications

• Currently licensed Registered Nurse in the State of Alabama (BSN preferred).
• 2 years of Inpatient Rehabilitation experience preferred.
• Previous experience in case management preferred.
• Previous experience with PR/Marketing preferred.

Skills

• Knowledge of CMS (Medicare) Rehab policies and guidelines for inpatient rehabilitation facilities.
• Ability to access, verify, and understand individual policy coverage and limitations.
• Negotiation skills with insurance providers.
• Education and marketing of referring Case Managers, Nurse Managers, and Physicians.
• Excellent communication and interpersonal skills.

Benefits

• Must adhere to the DCH Behavioral Standards.
• Must adhere to all DCH Health System policies and procedures.

Pay

TBD

Schedule

TBD