Home Care Liaison

• Responsible for the screening and accurate completion of referrals to ensure patients meet agency admission criteria and comply with state and federal regulations
• Processes referrals for all programs (Traditional, Peds, and Infusion Therapy) from hospital sites, MD offices, utilizing standard work and determines whether patient qualifies for home care based on established guidelines
• Verifies home health care benefits according to payor plans. Obtains authorizations for services as indicated
• Ensure physicians initial home care orders are obtained
• Identifies risk management situations and completes high risk referral process on all appropriate patients based on established guidelines
• Interprets company services, admission criteria and medical policies to referral sources and individuals seeking information
• Documents the initial plan of home health care and initiates interdisciplinary communication
• Interviews patients/families in the hospital or SNF, to assess and evaluate patient for home care appropriateness
• Works in conjunction with the care management staff to assist the patient/family in the initiation of home care services. Responds to inquiries regarding home care services
• Works within established productivity guidelines for assigned site(s). Reports productivity to supervisor daily
• Trains patient/families in using equipment (e.g. pump) at home
• Provide quality customer service
• promote collaboration/coordination between referral sources and home care services to promote continuity of care and utilization of home care resources effectively
• Acts as a resource to physicians, physician offices, patients and families, hospital and designated skilled nursing facility staff regarding types of services available and the criteria for home care, including Medicare guidelines
• Provides education to the care team as requested on services that may enhance the transition of care for patients including DME, Hospice, Palliative Care, Pediatrics and Home Infusion Therapy
• Maintains knowledge of Medicare, Medicaid and HMO procedures
• Attends site based multidisciplinary meetings that involve Advocate at Home patients
• Assures appropriate follow-up to patient satisfaction issues relating to home care services
• Provide courteous service to patients, families, staff, and physicians
• Accountable for insuring complete referral information is obtained for accurate and timely billing
• Maintains knowledge of agency payers including Medicare, Medicaid and contracted commercial insurance reimbursement guidelines
• Collaborate with insurance verification to insure optimal reimbursement
• Assists in the development of policies and procedures to ensure compliance with current practice standards
• Obtain Face-to-Face (F2F) encounter form for all Medicare, Medicaid and Medicaid pending patients during referral process or within first 7 days
• Educates physicians in the Face to Face process
• Teamwork
• Maintains own clinical skills and competency by attending monthly training and interdisciplinary team meetings
• Provide suggestions or improvements in current practices to improve quality, productivity and customer satisfaction
• Provide a positive attitude for Advocate at home through self-management
• Provide input regarding performance and compliance to standards of peers
• Adapt to changing business needs, conditions and work responsibilities
• Partner with peers to ensure productivity levels are achieved
• Follow standard operating procedures and guidelines during referral processing to insure consistent messaging and superior customer service is provided
• Participate in precepting new hire training and orientation
• Partner with your peers and other Advocate at Home product lines to provide complete and thorough patient hand-offs when appropriate

• Nurse, Registered (RN)
• RN with 3-4 years’ experience
• 1-2 years in home care preferred
• Very good communication skills
• Knowledge of Medicare rules and regulations
• Experience in multi-tasking on multiple computer systems
• Strong customer service skills
• Working knowledge of managed care environment
• Critical thinking skills
• Current RN licensure
• Ability to lift up to 35 pounds without assistance

1-2 years in home care preferred

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance