Rehabilitation Liaison

FMOLHS; Baton Rouge (LA); On-site; USD 65,000 - 85,000; Full time

Job summary

FMOLHS Our Lady of the Lake Rehabilitation Center in Baton Rouge seeks a Rehab Liaison to streamline intake and admissions for referrals. You will assess patients, coordinate with the care team, and ensure regulatory criteria under IRF-PPS are met.

You will collaborate with CMS payors, prepare pre-certifications, verify insurance, communicate with referral sources, and support discharge planning while maintaining strong relationships with providers and families.

Qualifications

• Three years of general or specialty practice experience.
• Associate's degree required.
• Current Louisiana RN license (if nurse), Current Louisiana LPN license or Current Louisiana Therapy license (PT/OT/ST, certification also required if ST) or Licensed Physical Therapy Assistant.

Responsibilities

• Evaluates rehab candidates referred to the center and determines medical necessity.
• Collaborates with the healthcare team to develop rehab treatment and discharge plans.
• Conducts weekly Admissions Committee meetings with Medical Director to determine appropriate admissions.
• Maintains archives of denied patient assessments for the required period.
• Develops and maintains professional relationships with referral sources for admissions and payor approvals.
• Obtains timely pre-certification and insurance verifications to support reimbursement for admissions.

Education

Associate's Degree

Job description

Works collaboratively with all members of the health care team and the patient/family to ensure prompt and efficient intake and admissions for all patients referred to OLOL Rehabilitation Center. The Rehab Liaison conducts patient assessments that include physical and psychological factors in order to plan for individualized continuum of care needs and that meet regulatory criteria under the IRF-PPS.

Responsibilities

• Evaluation and Collaboration
• Evaluates potential rehab candidates referred to OLOL Rehabilitation Center and functions as a liaison between OLOL and referral sources. Pre-admission assessments are conducted under the criteria and guidelines of CMSs IRF-PPS to ensure appropriateness of admission and to determine medical necessity.
• Works with healthcare team to develop rehab treatment/discharge plan.
• Conducts weekly Admissions Committee meetings with Medical Director to determine appropriate admissions and communicates information to nursing team.
• Maintains archives of denied patient assessments for the required period.
• Develops, builds, and maintains professional relationships with current or potential referral sources. Understands the capabilities of outside referral sources (such as home health, skilled nursing, etc) and the requirements for prior approval by payors for admission, continued stay, and discharge.
• Contributes to community and professional education. Assists with marketing efforts and customer satisfaction to ensure continuation and/or expansion of referral base. Participates in SPIRIT classes as requested to explain inpatient rehab, the referral process, rehab qualifications and expectations.
• Obtains timely pre-certification and insurance verifications from third-party payors to support effective reimbursement for admissions. Uses 3M and RUMBA programs to verify and document insurance information. Serves as liaison with HCR office for Medicaid applicants. Communicates with business office when insurance changes occur. Communicates insurance/payor information to patients and families.
• Understands IRF-PPS regulatory criteria and how to access resource information from CMS, MACs, etc. in order to maintain optimum reimbursement for the unit. Initiates and completes the IRF-PAI. Demonstrates ability to maximize financial outcomes with effective coding of the IRF-PAI.
• Collaborates with HIM and physicians to ensure appropriate capture of coding that supports medical necessity criteria. Communicates CMG information to the interdisciplinary team in order to facilitate care planning.
• Communicates approval status with referral sources, patients and families in a timely and effective manner. Interacts with team members to facilitate alternate placement in the event of denial or inability to admit to OLOL Rehabilitation Center.
• Communicates information with patients and families about the rehab physician, expectations of the inpatient program, discharge planning, family training and team conferences. Provides tours of the unit upon request.
• Demonstrates ability to access and utilize community resources. Is knowledgeable of ADA and other federal guidelines that support individuals with disabilities. Appropriately refers patients/families to community resources for additional support.
• Other duties as assigned
• Other duties as assigned

Qualifications

Experience - Three years in general or specialty practice

Education - Associate's Degree

Licensure - Current Unrestricted Louisiana RN license (if nurse), Current Unrestricted Louisiana LPN license or Current Louisiana Therapy license (if PT/OT/ST, certification also required if ST) or Licensed Physical Therapy Assistant

About Us

Our Lady of the Lake Health provides care for a full range of illness or injury, including those that are extremely complex, for both pediatric and adult patients. We are a nonprofit, Catholic healthcare ministry based in Baton Rouge with more than 7,500 employees and more than 2,900 active physicians, including more than 600 employed physicians.

We are committed to building a healthy community through excellence in patient care and education. Being our best earns us the trust and loyalty of our community, and our culture of excellence is directly tied to our mission. We believe in the value of receiving a broad range of healthcare from one trusted provider, and we pursue and provide a comprehensive range of advanced programs, treatments and technologies.

• Job Identification 49323
• Job Category Clinical_Care
• Job Shift Day
• Job Function Rehabilitation
• Worker Type Employee
• Regular or Temporary Regular
• Requisition Schedule Full-Time
• Hours of Schedule (e.g. M-F 8a-5p) 8-4:30
• Department Rehab Therapy Administrative-Lake Main Campus
• FMOLHS Company Code Our Lady of the Lake Hospital Inc