Hospital Liaison (HL), Registered Nurse (RN), Home Health

Organization:SCAH-Sutter Care at Home - South ValleyPosition Overview:The Sutter Care at Home Hospital Liaison facilitates admissions to Sutter Care at Home services by providing inpatient supportive care and seamless transition to home based care including, Home Health, AIM, or Hospice, depending upon the services available in that area. The Hospital Liaison assists the organization by assuring that the right care is provided at the right place and the right time.To accomplish this goal of right care, right place and right time, the Hospital Liaison uses established criteria to:a. evaluate the appropriateness of patients referred for home care servicesb. confirm the level of care most appropriate for the patientc. assess the patient’s readiness for discharged. facilitate ‘transition to home’ planning including assessing post-discharge needs and developing and implementing transition to home planHolding continuity of care as a priority, the Liaison communicates and coordinates with the larger health care team supporting the patient including hospitalist, hospital case management and nursing, patient’s physicians, and other healthcare providers involved in the patient’s care at home. The Liaison will attend rounds, facilitate orders, evaluate patients' care (medical, psycho-social and practical) needs, including medical eligibility for services, anticipated needs for equipment, medication, and transportation.The Liaison collaborates with the patients and their representatives, the patients' inpatient care teams, and outpatient care teams to identify patient/family needs and preferences as well as the overall care needs. The Liaison is responsible for helping the patients and their representatives determine person-centered goals.The Liaison serves as a clinical resource for patients, families, physicians, and facility staff for appropriate home placement, medication reconciliation, goals of care and identification of necessary support at home, as well as problem solving barriers or challenges related to the patient returning home.Job Description :Education

AA/AS required

BA/BS desired

Certifications

Current California RN license

Valid California driver’s license

Auto insurance

BCLS/CPR certification

Experience:

Minimum 3 years in nursing experience required.

Must have direct patient care experience within the last five years

One year experience in Home Health and/or Hospice setting must be within last three years

Recent experience in acute-care hospital setting; knowledge of discharge planning/case management strongly preferred.

Knowledge:

Must have clinical knowledge and critical thinking ability to create a viable and effective patient transition plan and identify barriers in service, effectively conduct verbal or written patient assessments, carry out the referral process, and coordinate with other individuals involved in the plan of care.

Understanding of homecare and hospice services and regulations, Title XXII, Medicare Conditions of Participation, reimbursement systems, home health and/or hospice accreditation requirements.

Knowledgeable about disease states and prognosis and how illness progresses clinically and functionally.

Knowledgeable of how the range of home care services can help patients with a wide range of needs from post surgical care to mom/baby care to palliative care to end of life care.

Skills

Self-starter with a high degree of initiative, motivation, flexibility, energy and creativity.

Ability to work as part of a team as well as form harmonious working relationships with internal and external customers.

Excellent collaborative and problem solving skills with customers and management.

Excellent organizational skills.

Must have excellent telephone, interpersonal and written communication skills.

Strong commitment to teamwork and customer service, both internally and externally, is required.

Experience with Microsoft Office suite and electronic health record strongly desired.

Must be flexible with schedule including, but not limited to, department rotation for weekend coverage.

May be asked to work in field providing homecare services as per changes in business needs and as skills and training allow

Must be able to develop an organized work plan in a high-volume environment with rapidly changing priorities.

Special Requirements

Must have current California Registered Nurse licensure (or higher), a current California driver’s license, reliable transportation and proof of liability insurance.

Must be able to orchestrate successful, complex discharge plans.

Must have strong clinical assessment skills

Must be able to deal with challenging work environment with time demands and occasional conflicting priorities.

Must have influencing skills to support patient/family appreciating the value and importance of home based services to support their needs for Home Health, SIPS, Private Care, AIM and Hospice as necessary.

Pay Range: 57.67 - 76.69 / hourThe salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.Job Shift:DaysSchedule:Full TimeShift Hours:8Days of the Week:Friday, Monday, Thursday, Tuesday, Variable, WednesdayWeekend Requirements:Rotating WeekendsBenefits:YesUnions:NoPosition Status:Non-ExemptWeekly Hours:40Employee Status:RegularNumber of Openings:1This position may regularly work, store, prepare, receive, unpack, transport, dispose of, or administer drug(s) identified as hazardous, or potentially hazardous, by the National Institute for Occupational Safety and Health (NIOSH) for purposes of USP 800.Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.