Rehabilitation Liaison

Position Summary

Serves as advocate for acute care patients to achieve the appropriate level of post-acute care.

Responsibilities

• Develops and establishes effective working relationships with all referral sources both internal and external.
• Facilitates professional communication with all members of acute care team, community organizations, and insurance companies.
• Coaches, encourages, and monitors teamwork and represents a positive first impression of the inpatient rehabilitation unit.
• First to assess patients, reviews their medical records and determines whether they should be admitted for care and or followed for future potential admission; requires decision-making for the appropriate level of care; may include admission/transfer reviews, utilization reviews, and surgical schedule reviews.
• Facilitates acute rehab admissions for those referrals that are appropriate for admission to the inpatient Rehab Unit.
• In collaboration with the acute care hospital staff and the rehab team, collects required patient information and completes all documentation that is required for admission.
• Assesses acute care patients to identify needs, rehab potential, resources and care goals.
• Participates in pre/post screening problem solving.
• Conducts tours and greets families and other decision-makers.
• Understands or facilitates pre-admission insurance authorization process.
• Maintains a working knowledge of the requirements of payers most frequently encountered in the patient population.
• Maintains responsibility for the communication of clinical information required by the payer.
• Utilizes expert insurance authorization process knowledge to prepare for customized reviews of the medical record and required authorization process including initial approval and subsequent approvals; may include prepping for the peer-to-peer reviews between the physician and insurance company.
• In collaboration with the acute care hospital staff, completes pre-screen process required for admission to Rehab Unit and enters completed screen into CMS tool within 24 hours.
• Collaborates with the referring hospital staff, inpatient staff and admitting physicians to determine an admission plan and admission date that is appropriate for the patient and the referring hospital.
• Completes admission and post-acute care placement work unique to inpatient rehabilitation in place of the acute care case manager to assist with through put and appropriate level of care.
• Demonstrates patient advocacy and sustains team focus and provides guidance in team decision-making.
• Explains the types of care and expectations of services the rehabilitation facility offers to the patient and families.
• Develops relationship in the community on behalf of the Rehab unit and the McLaren network by rounding on appropriate call points with goal of incremental referral development.
• Analyzes referral patterns of physicians or case managers and prioritizes to increase referral relationships for the McLaren network.
• Provides reporting trends and activity to the rehab management team to develops strategic initiatives for market development for assigned territory.
• Develops relationships with current and potential referral sources including insurance case managers and payer sources with education regarding rehabilitation.
• Develops and establishes excellent working relationships with network partners and their admissions team.
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
• May develop and conduct in-service training programs for internal staff and/or professional organizations.
• Complies with federal, state, and local legal and certification requirements by studying requirements; advising management on need actions; includes compliance with all health care regulations.
• Is aware of the compliance rule @ 60% and reporting any issues to management and PM&R Medical Director.
• Performs other related duties as required and directed.

Qualifications

Required:

• State licensure/certification in the field of nursing, physical therapy, occupational therapy or speech language pathology
• Associate degree in discipline
• 2 years' experience in related health care field

Preferred:

• Bachelor's degree and licensure/certification in rehab discipline

Schedule

• Full-time
• Daily Work Times: 7:00am-3:30pm
• Hours Per Pay Period: 80
• On Call: No
• Weekends: No