Rehabilitation Liaison

McLaren Health Care; Pontiac (MI); On-site; USD 52,000 - 76,000; Full time

Job summary

McLaren Health Care seeks a Rehabilitation Admission Specialist to advocate for acute care patients and ensure the appropriate level of post-acute care. You will establish effective relationships with referral sources, and coordinate admissions with the rehab team and payers.

Responsibilities include assessing rehab potential, facilitating admissions, and supporting pre-admission authorizations while developing referral networks across the McLaren network.

Qualifications

• State licensure/certification in nursing, physical therapy, occupational therapy or speech-language pathology.
• Associate degree required.
• Minimum 2 years of related health care experience.

Responsibilities

• Advocate for acute care patients to determine appropriate post-acute level of care.
• Facilitate communication among referral sources, hospital staff, rehab team, and payers.
• Assess patients for rehab potential and care goals; determine admission/transfer needs.
• Coordinate admission and post-acute placement within the inpatient Rehab Unit.
• Assist with pre-admission insurance authorizations and payer communications.
• Build and maintain referral relationships to support McLaren network growth.
• Ensure compliance with federal, state, and local health care regulations.

Education

Associate degree

Bachelor's degree in rehab

Job description

Position Summary

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

Essential Functions and 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.
• Employee is the first to assess patients, reviews their medical records and determines whether they should be admitted for care and or followed for future potential admission.This requires decision-making for the appropriate level of care; may include admission/transfer reviews, utilization reviews, and surgical schedule reviews.
• Employee 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.
• Employee assesses acute care patients to identify needs, rehab potential, resources and care goals.
• Employee participates in pre/post screening problem solving.
• Conducts tours and greets families and other decision-makers.
• Employee understands or facilitates pre-admission insurance authorization process.
• Employee maintains a working knowledge of the requirements of payers most frequently encountered in the patient population.Employee maintains responsibility for the communication of clinical information required by the payer.
• Employee 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.This 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.
• Employee 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.
• Employee demonstrates patient advocacy and sustains team focus and provides guidance in team decision-making.
• Employee explains the types of care and expectations of services the rehabilitation facility offers to the patient and families.
• Employee 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.
• Employee 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.
• Employee 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.This includes compliance with all health care regulations.
• Employee 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

Additional Information

• Schedule: Full-time
• Requisition ID: 26004788
• Daily Work Times: 7:00am-3:30pm
• Hours Per Pay Period: 80
• On Call: No
• Weekends: No