Regulatory Relations Liaison jobs in Hopkinsville, KY

ClearView Healthcare Management is seeking a full time Clinical Liaison for Western Kentucky area!

As the job title implies, a Clinical Liaison fosters the relationship between providers, families, patients and the facilities providing their care. Clinical Liaisons establish patients eligibility for care, communicate with families, and interact with a wide array of staff members from admission coordinators to case managers to physicians. The liaisons advocate for patients in a health care facility beginning with the pre-admission process and following through their release.

Essential Duties and Responsibilities of a Clinical Liaison

• Conduct pre-admission assessments to gather clinical and financial documentation in order to provide a quick response to patient referrals from hospital case managers, physicians and managed care organizations.
• Collaborate with discharge planners to prioritize referrals and identify patients for transition
• Encourage meaningful collaborations with hospital-based case managers on risk factors and care plans, expanding concentration of marketing focus on external relationships development beyond bed availability.
• Educate hospital staff, including Emergency Room physicians, about nursing centers clinical capabilities and appropriate patients for return to skilled nursing facility.
• Educate patients and family members in regards to services offered by skilled nursing facility and address and concerns/questions prior to admission, as well as explain options of care available.
• Identify special needs such as equipment, medication or services and ensure facility can meet needs of patient prior to admission
• Work with nurse managers to ensure proper training and education is available for high risk patients
• Visit with patient and family members at the bedside to complete assessments for risk identification and initiation of appropriate care plan.
• Maintain a working knowledge and adhere to applicable federal/state regulations including, but not limited to, laws related to patient confidentiality, release of information and HIPPA.
• Interact in a manner in which is professional, respectful, positive, customer-focused and which promotes trust.
• Verify health insurance eligibility and obtains benefits information.
• Reviews clinical documentation to ensure it supports the insurance requirements for approvals.
• Request pre-authorization for admission, including all the information required by the insurance such as correct CPT and ICD 10 codes an supporting clinical documentation. Submits appeals when request are denied, involving the provider when necessary.
• Acts as a liaison between patients, the providers and the health insurance to assist patient in understanding their financial responsibilities.
• Identify new opportunities of growth partnering by promoting new service offerings, offer solutions for target populations, provide rationale for increased patient bed-side access to complete risk assessment and initiative care plan.
• Develops relationships within the community on behalf of the skilled nursing facilities.
• Schedule speaking engagement at community events.
• Works with the facility marketing and sales team to bring awareness of the facilities strengths and services into the community at large.
• Market local facilities Core Competitive Advantages

Required Knowledge, Skills and Abilities

• Must demonstrate exceptional verbal and written communication skills.
• Strong interpersonal skills.
• Must be customer-service oriented.
• Experience working in healthcare industry, specific to acute care and skilled nursing care.
• Must have excellent computer skills and knowledge of databases.
• Must have knowledge of electronic health records.
• Must have knowledge of medical terminology and coding.
• Must have excellent organizational skills and be an effective time manager and multi-tasker.

Qualifications

• Bachelors Degree or equivalent experience
• Clinical or nursing experience a plus. Preferably experience in discharge planning, case management or utilization review.
• Familiarity with area hospitals, physicians and other referral sources.

EQUAL OPPORTUNITY EMPLOYER

The Facility is an equal opportunity employer. The Facility does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Facility will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Facility including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.