About The Position

Provides the consistency and predictability necessary to transition a patient's care between care settings or levels of care within a care setting in a timely fashion. Coordinates the discharge of the patient from the acute care setting or alternative site to Home Health Services. Ensures continuity of care by coordination of referrals and physician orders. Facilitates communication between staff, referral sources, insurance companies, and physician offices. Reviews orders for appropriateness for admission to Home Care and Hospice.

Requirements

  • Specialized Diploma Nursing
  • Less than 1 year
  • Ability to work with terminally ill patients.
  • Knowledge and understanding of medical terminology.
  • Knowledge of state, federal, local, and accreditation regulations pertaining to the delivery of home health services.
  • Knowledge of home care/hospice conditions of participation.
  • RN - Licensed Registered Nurse_PA - State of Pennsylvania Upon Hire

Nice To Haves

  • Bachelor’s Degree Nursing

Responsibilities

  • Facilitates patient transition to appropriate post acute level of care.
  • Evaluates patient appropriateness for Home Health Services through prescreening and communication with healthcare team members.
  • Collects data pertinent to the health care consumer’s health and situation from patient assessments that will impact the patient's care in the home setting.
  • Acts as a professional liaison between Home Health Services and community and hospital medical staff.
  • Promotes favorable outcomes through collaborative practice patterns and the appropriate and cost effective use of resources.
  • Identifies barriers to patient situation/complaint resolution and follows up with the appropriate resources or leadership.
  • Identifies problems which may compromise service, quality, safety, and or operational performance.
  • Coordinates the orders of treatments, therapies, and/or procedures in accordance with agency policies and procedures.
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