Clinical Evaluation Liaison

Position Duties:

• Identifies potential patients, performing level of care evaluations for admission to the hospital. These settings can include but are not limited to acute care facilities/hospitals, and skilled/assisted/independent living facilities, residential or day care facilities, or private residences.
• Collects and validates insurance information, confirming coverage eligibility and authorized length of stay.
• The admission screening and admission process is to be completed in a timely manner.
• Coordinates the patient admission, following established processes, which include, but not limited to completion of all consent paperwork, ambulance transport scheduling, admission call/email notification, and all other assigned admission process duties. Duties and processes are subject to change with any/all process improvement implementation.
• Educate patients, family members or significant others, referral sources, hospital personnel, external payers, external case managers, and others as requested/required, as to the hospitals program and facilities.
• Demonstrates positive communication between customers, co-workers, and supervisors always.
• Maintains high ethical standards.
• Maintains a thorough knowledge of facilities, products, services, and acuity trends.
• Prepares and submits activity reports/logs in the direction of the Admissions Manager or Regional Director of Business Development.
• Attends meetings as requested/required remotely.
• Develops rapport with referral sources, clients, and their family members.
• Promotes good public relations with patients, healthcare providers, and other involved people.
• Always exhibits the utmost professional behavior, as a facility representative.
• Takes Hotline calls as assigned.
• Understands that this position requires constant communication with the team and that the employee is always available by phone during on-the-clock hours. Promptly responds to calls/texts.
• Markets to assigned hospitals, including emergency departments, case management teams, and various other hospital departments. This includes cold calling, conducting in-services, training, and various other educational methodologies to ensure all hospitals are familiar with the products and services of the hospital.
• Displays concern and initiative. Is resourceful and calm in emergencies/crisis situations.
• Cooperates and maintains good rapport with nursing staff, medical staff, other departments, and visitors, as well as outside referral sources, hospitals and physicians.
• Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital policies and processes that apply to assigned duties.
• Complies with hospital expectations regarding ethical behavior and standards of conduct.
• Maintains a professional approach with confidentiality. Assures protection and privacy of health information attained through written, electronic or oral disclosures. Understands that transportation of protected health information is necessary at times and will follow established guidelines for protection and destruction of such information.
• Complies with federal and hospital requirements in the areas of protected health information and patient privacy.
• Performs discharge follow up evaluation in accordance with company process and at the direction of the Admissions Manager and/or Director of Patient Relations.
• Relays pertinent feedback, positive or negative, to Admissions Manager for strategic resolution (if applicable).

Minimum Qualifications:

Education: Must be a graduate from an accredited school of nursing, Social Work, or related field.

Experience: Prefer 6 months of RN, LPN, LMHC or Social Work experience as well as experience in marketing and or community relations.

Licensure: Currently licensed as a Registered Nurse, LPN, or hold a master’s degree and a license in social science field.

Skills:          Must demonstrate expertise in analysis, decision making, time management, oral and written communication, and computer use. Familiarity with the resources available for use in evaluating regulations. Good skills and understanding of the insurance and managed care areas. Ability to function independently. Able to communicate the hospital objectives and goals to outside individuals. Able to effectively seek out and communicate with outside referral sources.