AccentCare - Vicksburg, MS
posted 7 days ago
The Transitional Care Nurse is responsible for partnering with assigned physician(s) to achieve optimal patient satisfaction & outcomes by serving as the liaison and clinical coordinator between AccentCare agencies and assigned physician(s) on shared patients. The role is responsible for driving referral growth by educating key personnel on AccentCare programs in assigned physician practice(s). Establish and maintain relationships with physicians to ensure timely signing of orders. Solely responsible for obtaining assigned physician's signature on all orders generated from the agency and ensuring they are received by the appropriate branch. Communicates information and status reports from patient care staff to the physician; ensures that physician conference information is relayed to the physician in a timely manner and his/her response is recorded in HCHB. Works collaboratively with team members; promotes collaborative relationships with vendors, community and referral resources. Performs transfer of accurate, pertinent patient information between levels of care through collaboration with Care Transitions Nurses, when applicable. Performs follow-up calls to patients and providers regarding their experience and issue resolution. Participates in departmental improvements, Company initiatives and performs data collection for measurement of projects. Documents accurately and timely all interventions and necessary patient-related activities. Follow-up on outstanding orders in accordance with current policy. May perform tasks such as routine utilization reviews, securing community resources/information or other tasks as related to clinical specialty. May perform secretarial/cross coverage where needed. Monitors hospitalized patients for assigned physicians; identifies home health candidates; educates patients on availability of home health services and options; and coordinates the patient's discharge from hospital with referral to HHA of choice; works closely with clinical operations to make sure all collateral, training, and support materials are in compliance with company policies and procedures.