Lead Clinical Navigator - Miamisburg, United States - PAM Health

Description

Lead Clinical Navigator

Under the direction of the Director of Strategic Initiatives (DSI), assists in the training and management of the business development team to include Clinical Navigators, Physician Navigators, and other individuals as directed.

Provides marketing support to Clinical Navigators and other business development team members at various hospitals and clinics as needed for sales presentations.

Cultivates referral relationships, manages assigned territory, and makes sales contacts as well as analysis of referral and admission data from assigned territory.

Works collaboratively with business development team members including the Director of Admissions and Admissions staff, and well as nursing and other internal and
external staff to facilitate the referral conversion. Able to perform patient evaluations for admission to Post Acute Medical.

Provides feedback and recommendations for program development and quality improvement initiatives related to customer service, the referral and admission process and patient and referral source satisfaction.

Develops and maintains excellent relationships to all stakeholders including prospective patient, family members, physicians, ICU and floor nurses, discharge planners, case managers and payer representatives, Performs other related duties as assigned or requested.

This is an exempt position.


RESPONSIBILITIES

Management / Supervision

• Effectively serves an extension of the DSI in the field: Assisting Clinical Navigators with marketing presentations, provides ongoing sales training to new and current Clinical Navigator team members, and assists in the development of overall department marketing plans and strategies.
• 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 administrator on a daily basis to optimize census management and case finding strategies.
• Follows-up on all medical denials in person to re-evaluate potential for admission.
• Conducts exit interviews with patients prior to discharge from the Post Acute Medical hospital or confers with hospital management after interviews to ensure feedback is obtained.
• Conducts follow up visits with referral facilities to ensure satisfaction and service levels were met.

Education

• Identifies and educates new referral sources to Post Acute Medical programs and services.
• Assesses and conveys stakeholder needs. Establishes and maintains strong relationships with providers through ongoing assessment and servicing of their client's rehabilitation/LTAC needs.
• Schedules educational inservices to educate referral services about Post Acute Medical programs and services; works closely with the PAM admissions department and Director of Strategic Initiatives to achieve targeted census goals and meet assigned objectives on a weekly, monthly and quarterly basis. Communicates clearly, concisely and accurately.
• Provides or arranges educational presentations to referral sources (physicians, discharge planners), families and to the community members as requested.
• Coordinates and schedules professional, family and/or potential patient tours of all facilities.
• Gathers information on health care providers in the Post Acute Medical service area and forwards to management, including opportunities for contracting with managed care companies and providers.

Public Relations

• Drafts press releases, coordinates media events, and advertising through the DSI.

Pre-Admission Assessment

• Displays knowledge of both inpatient rehabilitation and long term acute care admissions criteria for pre-assessment analysis.
• Coordinates and completes on-site pre-admission assessments on potential patients unless geographically prohibitive or competitive time of admission will not allow. In the assigned market uses the fast track process to facilitate referral conversions. 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 liaison to the Admissions office for insurance companies and provides clinical information to obtain pre-certification from payers.
• After reviewing medical record and interviewing patient/family, obtains facility admission information to support the admission process; makes a recommendation regarding acceptance or denial and communicates status of admission to referral source as directed by the admissions department.
• Enters assessment data on the contact database (Upshot) and ensures accuracy of pre-admission information for evaluation purposes.
• Initiates FIM scoring based on record review and patient observation.
• Evaluates social supports and initiates discharge planning process.
• Assists in the development of new programs and services through ongoing assessment of the needs of professionals, families, and patients.
• Remains current on new programs and services in the Post Acute Medical System through frequent communication and facility visits.

Documentation Reporting

• Effectively and efficiently maintains contact management database (Upshot) to support Fast-Track admission process and system analysis of market trends for CARF requirements.
• Provides periodic verbal/telephone/email update on activities and market trends as requested.
• Maintains a resource library of articles and information for distribution to professionals, community members, families and potential patients to assist them in understanding rehabilitation and the various disability groups served.

QUALIFICATIONS

Education and Training: Degree from an accredited college or university in a health field, preferably nursing. Current licensure in nursing or therapy is preferred. Prior marketing and/or rehabilitation/LTACH experience preferred.


Experience: Minimum of seven years of experience in healthcare marketing.


Knowledge, Skills, and Abilities:

• Effective management and training skills related to marketing, sales and territory management.
• Excellent clinical and assessment skills.
• Effective presentation and training skills.
• Excellent written and oral communication skills.
• Effective crisis management skills, with demonstrated facilitation and problem solving experience.
• Effective team leadership skills.
• Knowledge of PPS payment/reimbursement systems.
• Knowledge of patient rights and commitment to patient advocacy.
• Ability to collect, documents, and analyze data.
• Word processing and data entry skills.
• Network access to community, state, and national resources and health services organizations.
• Excellent relationship management skills with referral sources and physicians.

ABOUT US

PAM Health is committed to being the most trusted source for post-acute services in every community it serves by utilizing experienced and dedicated staff to provide high quality patient care and customer service. With over 44 Long Term Acute Care and Rehabilitation hospitals and 16 Outpatient Clinics currently in operation across the country, we are proud to offer services including comprehensive wound care, aquatic therapy, ventilator weaning, amputation treatment, pain management and much more.

Joining our PAMily allows you to work in a collaborative environment with colleagues and leadership with exposure to a variety of patient care levels.

Aside from our competitive pay, generous paid benefit time, and excellent insurance options, you will also have opportunities for professional growth through our Education Advancement Program.

We are excited to learn more about you and hope that you consider joining us on a shared mission to improve the lives of others by being an integral part of our We Care Program.

Please take a moment to visit us online for a comprehensive look at how we're able to positively impact our local communities.

PAM Health does not discriminate and does not permit discrimination, including, without limitation, bullying, abuse or harassment, on the basis of actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status, or based on association with another person on account of that person's actual or perceived race, color, religion, national origin, ancestry, age, gender, physical or mental disability, sexual orientation, gender identity or expression or HIV status.