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The Transitional Care Liaison is an integral member of the health care team in representing the organization to the greater community of health care providers by marketing the agency services to influencers using a strategic marketing plan for the purpose of generating consistent admissions from physicians, hospitals, and post-acute care providers to maintain a census level and payer mix at or above budget.
RESPONSIBILITIES
Community and Provider Relations
- Develop relationships with case managers, social workers and discharge planners to generate and facilitate new referrals.
- Meet with patients and/or families to evaluate their need for home health and hospice services.
- Obtain pertinent demographic and medical information for writing up referrals so that appropriate care can be initiated upon patient discharge.
- Communicate with hospital staff when the organization’s patients return to the hospital, either through the ER or for planned admissions to obtain a resumption of care when they are discharged.
- Communicate with clinical staff/team managers at our agency about patient admissions, expected discharge dates, and any other problems or concerns related to our ability to care for the patient.
- Meet with patients and families in the hospital setting to explain the organization’s services after receiving permission from hospital to follow patient.
- Discuss agency hospice and private duty services with potential referrals and write up referrals as necessary.
Communication
- Communicate with key hospital staff when Accountable Care Organization (ACO)beneficiaries are admitted to the hospital to obtain orders for home health care, hospice, or Home to Stay.
- Communicate with office clinical staff and team members regarding ACO patient admissions, expected discharge dates and other problems or concerns related to our ability to care for the patient.
- Communicate with ACO beneficiaries’ primary care physician offices to obtain timely physician appointments following post hospital discharge.
Quality and Compliance Management
- Understand and easily access the company’s EMR, as well as other EMR computer systems in multiple healthcare facilities.
- Review patient medical information and write up referrals so that appropriate care can be initiated upon patient discharge.
- Secure appropriate face to face documentation from discharging physician.
All other duties as assigned.
QUALIFICATIONSEducation
- Bachelor’s degree in business, marketing or nursing required; or
- Current unencumbered license for the state of Ohio to practice as a Registered Nurse (RN), Licensed Practical Nurse (LPN) required.
Experience
- Five years experience in nursing required.
- Two years experience in a hospital setting required.
- Strong knowledge of the full continuum of care and the eligibility requirements for home health, hospice, skilled nursing, and assisted living required.
- Proficiency with Windows, Microsoft Office (Word, Excel, PowerPoint), and the internet required.
Other Requirements
- Must be able to read, write, speak, and understand the English language.
- Must possess a valid driver's license and acceptable driving record. Must be insurable under professional liability and crime coverage policies as specified by insurance carrier underwriting standards.
Ohio Living Home Health and Hospice in Greater Toledo is a premier provider in Defiance, Erie, Fulton, Hancock, Henry, Lucas, Ottawa, Sandusky, Seneca and Wood counties. Services include hospice and palliative care, private-duty home care, long-term nursing care, physical/speech/occupational therapies, home health aides, social work services, medication administration, wound care management, IV therapy and more. Most importantly, we’re a company that:
- chooses to operate as a faith-based, not-for-profit organization
- makes its mission the heart of our organization
- has a reputation for consistently exceeding the needs and expectations of those we serve
- provides an engaging, team-oriented workplace dedicated to career, family and faith
- commits to recognizing our employees for a job well done
We’re looking for people who:
- have a passion for helping people, solving problems and contributing to a positive work environment
- are excited about bringing their personal standards and ideals to work each day
- understand that HOW you do your job is just as important as WHAT you do in your job
Why work at Ohio Living Home Health & Hospice?
Depending on an employee’s status, they may benefit from:
- competitive wages
- medical, dental, and vision insurance
- 403b retirement savings
- paid time off including your birthday
- training, continuing education, and education assistance
- pay advances up to $500
- the latest technology
- mileage reimbursement
- unlimited career opportunities
- and much more!
Who is Ohio Living?
Headquartered in Columbus, Ohio Living is one of the nation’s largest not-for-profit, multi-site senior living organizations. Since its founding in 1922, Ohio Living has defined the highest standards of quality of life for adults through its 12 life plan communities and Ohio Living Home Health & Hospice in 50 Ohio counties.
Our mission is to provide adults with caring and quality services toward the enhancement of
physical, mental and spiritual well-being consistent with the Christian Gospel.
Our Values:Care Integrity Customer Service InnovationFinancial Stewardship Leadership Inclusion