Weekend Intake Registered Nurse, RN

Job Profile Summary

This role focuses on evaluating, developing, recommending, implementing, and carrying out policies and procedures related to high quality patient care. It also involves performing Care Navigation duties, such as guiding patients through the healthcare system and overcoming obstacles.

Job Overview

Serves as a resource for referral sources and the public regarding services provided, third party regulations, determination of home care eligibility, and appropriateness for home care. Provides resource information if patient/client is not eligible or not appropriate for home care.

Minimum Qualifications

• Candidates must hold an active RN license in the state where services are provided and may not work in states where they are not licensed.
• If additional state licensure is required, it must be obtained within sixty (60) days.
• Two (2) years of visiting nurse experience.

Duties and Responsibilities

• Obtains necessary patient identification, medical and financial information required for the nurse and/or therapist to make the initial home health visit.
• Documents important information on the agency’s “Request for Service” form and creates a case in Forcura and the current EMR.
• Attempts to assess if the potential patient can manage safely in their home and assists referral source in making decisions regarding safe discharge planning.
• Affords assessment of if the patient is eligible for home health services under their payment source.
• Establishes Home Bound status and if medically necessary/reasonable requests.
• Effectively manages HHVNA and Hospice referrals for patients who do not have insurance coverage for requested services and consults with other RNs as needed.
• Communicates the mission of the agency to provide care for patients regardless of ability to pay, and manages expectations about the available services.
• Provides information of other community resources to the referring party if needed and if patient does not meet home care criteria.
• Communicates with billing to verify atypical insurances as requested by referral sources and to support UR and Clinical Staff.
• Identifies pre-admit evaluated patients and works to determine home care eligibility and appropriateness for home care.
• Communicates with department manager to determine acceptance of referral.
• Follows referral department guidelines regarding orders required to initiate home health services. All physician orders/approvals are noted in the referral orders.
• Prioritizes completion of referrals based on clinical priority, patient safety, and insurance precertification.
• Effectively manages the time it takes to complete referrals by understanding what information is desirable vs necessary.
• Uses critical thinking and problem-solving skills to resolve referral issues limiting the need to involve the referral source.
• Utilizes clinical judgment to determine optimal services to manage a patient safely in the home setting.
• Adheres to referral order documentation guidelines developed to guide agency initiatives.
• Maintains productivity standards as defined by the department standards.
• Obtains prior authorizations and pre-certifications as required by insurer.
• Completes e-tracking and Forcura case final verification to inform clinical departments on admission state, diagnoses and priority of ordered care.
• Keeps the Intake clinical manager informed of any problems communicated by referral sources.
• Reports any changes or trends noted in referral patterns to Department manager.
• Keeps abreast of third-party regulations and insurance companies and HMO’s.
• Identifies opportunities to generate potential referrals for all agency services to meet the care needs of the patient.
• Selects the correct referral sources in the referral source tab to enable accurate data collection.
• Keeps department Clinical Lead informed of issues related to workflow.
• Reaches out to other RNs and/or Intake Clinical Manager to determine if a referral is to be accepted or declined.
• Reports Compliance concerns to the CEO or Chief Compliance Officer when applicable.

Physical Requirements

• Frequently required to move about inside the office to access file cabinets, office machinery, etc.
• Ability to remain in a stationary position 90% of the time.
• Occasionally lifts and/or moves up to 10-25 pounds.
• Constantly operates a computer and other standard office equipment such as copy machine, phones, photocopier, fax machines and computer printers.
• Specific vision abilities apply including close vision, distance vision and ability to adjust focus.
• Noise level in the work environment is usually moderate.

Skills & Abilities

• Ability to function well in very busy situations.
• Responsible and reliable.
• Good organizational skills.

Pay Range

$42.00 - $47.41