Nurse Liaison - Remote (New York) Sign on Bonus!
Care Centrix New York, NY
The Nurse Liaison is responsible for an assigned caseload at acute and post-acute care facilities. The Nurse Liaison will conduct in person, on site initial face to face outreach with patients to introduce the HomeSTAR program, gather patient demographics and collaborate with hospital clinicians, patient and family to develop a discharge path of care. The Nurse Liaison will coordinate post-acute care services for the patient and collaborate with HomeSTAR homecare agencies on post-acute care plan of care, authorizing services as medically necessary.
- Manages the transition of assigned HomeSTAR patients from acute care setting to the skilled nursing facility and/or home setting utilizing face to face and telephonic outreach to accomplish the goals of the HomeSTAR Program. Care coordination and facilitation with hospital discharge planners, case managers and hospitalist to obtain HomeSTAR orders for engagement.
- Authorize admission and continued stay at Skilled Nursing Facilities and Home Health care using approved medical care guidelines and collaboration with physicians and professionals within the healthcare setting.
- Engages and coaches the patient/caregiver assigned using telephonic outreach and standard assessments, patient care plans, and document progress in Homebridge care coordination platform. Documents all interactions, problems, goals and interventions as well as criteria met ensuring documentation guidelines are maintained.
- The Nurse Liaison will also communicate patient plan of care and discharge status with the Primary Care Physician and/or Specialist.
- Works closely with the HomeSTAR patient home health agency nurse to facilitate education and adherence to establish health care goals and care plan.
- Facilitates obtaining appropriate home health physician orders for the home care services.
- Acts as a clinical resource for unlicensed HomeSTAR Care Coordinators, providing clinical expertise and helping to clarify referral source directives. Receives/responds to requests from unlicensed staff regarding scripted clinical questions and issues.
- Identifies patients who meet criteria for other Health Plan programs upon patient graduation from the HomeSTAR program and communicating patient information to the Health Plan contact(s).
- Participates in performance and operational improvement activities. Contacts referral sources to advise them of referral status. Relays referral status and updates to the assigned health plan case managers.
- Communicates customer service/provider issues to supervisor for logging and resolution.
- Participates in and contributes to ongoing quality assessment/improvement activities, ensures the collection of data for improvement analysis and prepares reports as requested.
- Assists team in implementing and maintaining standardized operational processes to ensure compliance to company policies, legal requirements and regulatory mandates.
- Participates in implementing / maintaining operational processes to ensure compliance to company policies, legal requirements and regulatory mandates.
- Participates in special projects and performs other duties as assigned.
- Must be willing to travel to acute and post-acute care facilities within the Candidates local assigned geographic area 25% to 50%
- Current and unrestricted license for the market (state) of practice as a Registered Nurse. Minimum five years of nursing experience, preferably with a geriatric population.
- Expertise in Utilization Management and knowledge of URAC standards. Broad knowledge of health care delivery/managed care regulations, contract terms/stipulations, prior utilization management/case management experience, and governmental home health agency regulations required.
- Excellent negotiation, communication, problem solving and decision making skills also required.
- Ability to travel frequently to hospitals, skilled nursing facilities, and physician practices within the geographic location assigned.
- Candidate will possess excellent communication (verbal/written), organizational and interpersonal skills.
- This position requires high level clinical knowledge, communication, customer service and problem solving skills, as well as, the ability to effectively interact with all levels of management and a highly diverse clientele. Must have strong organizational skills and be able to effectively manage and prioritize tasks.
- Works independently, utilizing sound clinical judgment and critical thinking skills under minimal supervision.
- Must have a strong commitment to quality and standards.
CareCentrix maintains a drug-free workplace in accordance with Florida’s Drug Free Workplace Law.