Resource Physician Navigator | PAM Health Corporate

PAM Health Corporate Office•Enola, PA

2d•Hybrid

About The Position

This position works under the direction of the Executive Vice President Business Development and serves as a physician relationship and referral development resource supporting PAM Health hospitals and markets. Cultivates physician and referral relationships, supports census growth initiatives, completes patient assessments, and assists facilities with operational and business development support.

Requirements

Must have a minimum of two years of experience in healthcare sales and/or marketing.
Strong interpersonal, communication, and organizational skills.
Ability to work independently and adapt quickly to changing operational needs.
Knowledge of healthcare admissions processes, payer authorization requirements, and referral management.
Strong interpersonal, communication, organizational, and relationship management skills.
Ability to collaborate effectively with corporate and local leadership teams, referral sources, and physicians.

Nice To Haves

License in nursing, therapy, or social work or significant healthcare experience in marketing preferred.
Computer literate with the ability and desire to enhance skills utilizing PAM Health information systems.
Prior experience calling on physicians and referral sources preferred.

Responsibilities

Maintains responsibility for patient referral until patient admits to PAM Health.
Displays knowledge of both inpatient rehabilitation and long-term acute care (LTACH) admissions criteria for pre-assessment analysis.
Coordinates and completes on-site pre-admission assessments on potential patients unless geographically prohibitive or operationally impractical. Completes phone/FAX assessments if geographically prohibitive. Documents pre-admission assessments legibly, accurately, and completely in the approved format.
Reviews medical record of referred patient and identifies all aspects related to pre-certification financial coverage and admission criteria. Serves as a navigator to the Admissions office for insurance companies and provides clinical information to obtain pre-certification from payers.
Obtains and reviews admission information by evaluating the patient's medical record and interviewing the patient and/or family to support the admission process. Assesses the patient's appropriateness for admission, recommends the appropriate level of care, and communicates the admission status to the referral source in coordination with the Admissions Department.
Orients patient and/or family to facility services, including length of stay. Educates, supports and serves as a resource to family members of current, past, and potential patients.
Communicates with facility Admissions department and facility CEO on a daily basis to optimize census management and case finding strategies.
Follows up on all pending as well as medical denials in person to re-evaluate potential for admission.
Conducts follow up with referral facilities to ensure satisfaction and service levels were met.
Provides temporary market support during hospital openings, staffing transitions, census growth initiatives, and operational needs.
Identifies and targets new referral sources for PAM Health within assigned territory and markets.
Establishes and maintains strong relationships with referral sources through ongoing assessment and servicing of their rehabilitation and LTACH needs.
Performs in-person appointments to market PAM Health programs and services to designated referral sources and meet assigned objectives.
Maintains an excellent understanding of inpatient and outpatient programs, including features and benefits of PAM Health services throughout the system.
Uses approved account management systems to maintain customer profiles and referral source activity.
Uses prospecting and relationship management methods to generate leads and referral opportunities.
Supports referral and admission goals for assigned facilities and territories.
Participates in community events, health fairs, networking opportunities, and professional healthcare organizations.
Attends required Business Development meetings, operational calls, and educational presentations.
Functions as a physician and referral development resource supporting facilities and markets as assigned.
Identifies and educates new physician and referral sources to PAM Health programs and services.
Assesses and conveys stakeholder needs while establishing and maintaining strong relationships with providers and referral sources.
Schedules educational in-services and coordinates with Admissions departments, DSIs, CEOs, and leadership teams to support census goals and market strategies.
Provides or arranges educational presentations to physicians, referral sources, discharge planners, families, employers, and community members as requested.
Coordinates and schedules professional, family, and potential patient tours of facilities.
Gathers market intelligence and information on healthcare providers within facility service areas and forwards opportunities to leadership.
Assists in the development of new programs, enhanced services, and partnership opportunities through ongoing assessment of market and stakeholder needs.
Remains current on new PAM Health programs and services through frequent communication and facility interaction.
Coordinates managed care relationship opportunities and supports appointments with managed care companies and PAM Health leadership as appropriate.
Effectively maintains logs of pending cases, referral activity, and physician interactions.
Provides periodic verbal, telephone, and email updates on activities, operational barriers, and market trends as requested.
Maintains customer profiles, referral contacts, and related information within approved account management systems.
Completes required reports, territory planning documentation, expense reports, and updates in a timely manner.
Identifies areas of opportunity and communicates recommendations that support market growth and referral development.
Maintains the highest level of customer service via courtesy, compassion, responsiveness, and positive communication.
Promotes the mission and vision of PAM Health within the work environment and community.
Respects dignity and confidentiality by adherence to all applicable policies and procedures.
Demonstrates professionalism and adaptability while supporting varying markets, leadership teams, and operational environments.
Works in a manner that promotes safety; wears clothing appropriate to the performance of the job.
Participates in OSHA required training.
Follows universal precautions as appropriate for position; complies with Employee Health requirements for continued employment.
Reports unsafe practices to management.
Knows own role in case of an emergency.