Clinical Liaison - Skilled Bed

Summary: Responsible for establishing relationships with case coordinators, physicians, payors, and other referral sources. Ensures appropriate patient placement through clinical screenings and assessments in collaboration with both hospital Case Coordination and the Critical Access Hospital/Swing Bed Teams. Works closely with hospital Case Coordinators.

Essential Functions and 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 Critical Access Hospital Swing Bed Program. Performs initial assessment on patients, reviews their medical records and determines whether they should be admitted for care and or followed for future potential admission. This requires decision-making for the appropriate level of care; may include admission/transfer reviews, utilization reviews. Facilitates swing bed admissions for those referrals that are appropriate for admission to the Critical Access Hospital Swing Bed Programs. In collaboration with the acute care hospital staff and the swing team team, collects required patient information and completes all documentation that is required for admission. Assesses acute care patients to identify skilled nursing needs, resources and care goals. Participates in pre/post screening problem solving. Greets families and other decision-makers. Understands or facilitates pre-admission insurance authorization process. 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, which may include prepping for the peer-to-peer reviews between the physician and insurance company. 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. Explains the types of care and expectations of services the swing bed programs offer to the patient and families. Develops relationships with current and potential referral sources including insurance case managers and payer sources with education regarding swing bed programs.

Education: Registered Nurse: Associate of Science in Nursing (ASN); Bachelor of Science in Nursing (BSN).

OR

Licensed Practical Nurse: Graduate of a school of nursing.

Licensure/Certification: State licensure as Registered Nurse or Licensed Practical Nurse.

Experience: Two years related experience working in a clinical healthcare setting or previous experience working in a skilled nursing facility.

Other Qualifications: Demonstrated competency with the preadmission process including assessments and relationship building in swing bed/skilled nursing setting or in another post-acute care setting preferred. Demonstrated computer proficiency. Must have good verbal and written communication skills. Must be able to demonstrate organizational skills and ability to plan, design, and develop education plans.