Hospital at Home Liaison (On-Site)

Advocate Health and Hospitals Corporation•Charlotte, NC

5d•Onsite

About The Position

The Hospital at Home Liaison is responsible for collaborating with hospital and/or clinic caregivers as a resource regarding home care services and providing general education of services. This role educates patients/families on home care, palliative care, and hospice services, answering questions to allow informed decisions regarding their discharge plan for post-acute care. The Liaison regularly attends outcome facilitation team meetings on hospital units to provide input on home-based services, communicates with social workers or case managers on complex cases, and serves as the main communication link between patients, providers, and external partners. They initiate the transfer process to the Hospital at Home program, including provider notification and care team coordination, address patient and caregiver questions by reviewing the admission packet, and obtain formal patient consent after medical clearance. The Liaison coordinates and executes key steps for a smooth transfer, including notifying the care team, documenting acceptance, confirming logistics, and ensuring patient needs like medications, oxygen, and equipment are addressed before departure. The role also involves performing patient assessments (skin, cognitive, mobility), applying critical thinking to evaluate the patient holistically, and demonstrating knowledge and skills for age-appropriate care, including understanding growth and development principles.

Requirements

RN PT, OT or SLP Certification / Registration / License
Licensed in state the teammate practices – RN, PT, OT or ST License
2 years of health care related experience
Strong understanding of the workflows of Hospital at Home, broad understanding of payors, and able to complete a medical, physical, and cognitive screen of the patient.
Excellent communication skills.
Must be able to speak clearly and hear to communicate with people in person or over the telephone.
Good organizational, analytical and problem-solving skills.
Proficiency in clinical skills with the ability to work under direction and make sound judgments.
Demonstrated ability to educate clinical staff and the community.
Demonstrated ability to work well with physicians and other professionals in a direct and positive manner.
Ability to assess data reflecting the patient's status and the ability to interpret the appropriate information needed to identify each patient's requirements relative to their specific needs.
Must have a tolerance for differences and an appreciation of multi-culturalism and diversity of the patients and their families.

Nice To Haves

3 years
Ability to take initiative, strong verbal and interpersonal skills

Responsibilities

Collaborates with both hospital and/or clinic caregivers as a resource regarding home care services and provides general education of services.
Educates patients/families on home care, palliative care, and hospice services and is available to answer questions allowing patients to make an informed decision regarding their discharge plan for post-acute care.
Regularly attends the outcome facilitation team meetings on the individual hospital units to provide input regarding services that could be provided in the home.
Communicates with social workers or case managers on complex cases.
Serve as the main communication link between patients, providers, and external partners.
Initiate the transfer process to the Hospital at Home program, including provider notification and coordination with the care team.
Address any patient and/or caregiver questions and concerns through review of the admission packet.
Obtain formal patient consent to the program after medical clearance provided by provider.
Coordinate and execute the key steps required for a smooth and timely transfer to Hospital at Home. This includes notifying the care team, documenting acceptance, confirming logistics, and ensuring the patient’s needs—such as medications, oxygen, and equipment—are addressed before departure.
Performs assessment of patient to include skin, cognitive, mobility.
Applies comprehensive critical thinking to evaluate the patient wholistically.
Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served.
Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the departmental policies and procedures.
Age-specific information is developed further in the departmental job standards.

Benefits

Comprehensive suite of Total Rewards: benefits and well-being programs
Competitive compensation
Generous retirement offerings
Programs that invest in your career development
Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program