Rehabilitation Liaison

McLaren Health Care•Pontiac, MI

About The Position

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

Requirements

  • 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

Nice To Haves

  • Bachelor’s degree
  • Licensure/certification in rehab discipline

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.
  • Assesses patients, reviews their medical records and determines whether they should be admitted for care and or followed for future potential admission.
  • Makes decisions for the appropriate level of care; may include admission/transfer reviews, utilization reviews, and surgical schedule reviews.
  • 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.
  • Assesses acute care patients to identify needs, rehab potential, resources and care goals.
  • Participates in pre/post screening problem solving.
  • Conducts tours and greets families and other decision-makers.
  • Understands or facilitates pre-admission insurance authorization process.
  • Maintains a working knowledge of the requirements of payers most frequently encountered in the patient population.
  • Maintains responsibility for the communication of clinical information required by the payer.
  • 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.
  • Preps for the peer-to-peer reviews between the physician and insurance company.
  • 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.
  • 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.
  • Demonstrates patient advocacy and sustains team focus and provides guidance in team decision-making.
  • Explains the types of care and expectations of services the rehabilitation facility offers to the patient and families.
  • 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.
  • 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.
  • 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.
  • Ensures compliance with all health care regulations.
  • Is aware of the compliance rule @ 60%25 and reporting any issues to management and PM&R Medical Director.
  • Performs other related duties as required and directed.
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