Reimbursement Services Director - Home Care jobs in Lexington, KY

SUMMARY: Ensures residents and families are assisted with personal and environmental difficulties which predispose illness or interfere with obtaining maximum benefits from medical care by performing the following duties:

ESSENTIAL DUTIES AND RESPONSIBILITIES: An individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The requirements listed below are representative of the knowledge, skill, and/or ability required. Other duties as assigned.

Regularly oversees and assists with resident evaluation and treatment. This includes but is not limited to: communicating with and evaluating resident(s); providing services to promote optimum resident social and mental health; promoting understanding by staff of social and emotional factors of health problems; working cooperatively with interdisciplinary team to develop, implement, and regularly evaluate resident plans of care; attend care conferences; communicate resident concerns, preferences, choices, customs, and needs to interdisciplinary team and direct care staff.
Assists with admission, preadmission, transfer and discharge of resident(s). This includes but is not limited to: evaluating mental health of prospective admissions; care planning for admissions as to mental health, social services, resident and family preferences; assists with the provision of transfer services; assists with evaluation of resident(s) for discharge potential and provision of comprehensive discharge planning services; coordinates post discharge care and services; prepares discharge summaries for release with proper consent.
Regularly communicates with resident(s) and families regarding social services. This includes but is not limited to: evaluating mental and cognitive functioning of residents and social needs; communicating with families regarding resident interests and preferences, as well as importance and purpose of medical recommendations; planning and/or otherwise promoting activities to enhance resident social and mental well-being.
Ensures proper documentation is maintained. This may include but is not limited to: update and audit of social services assessments, completion of RAI/MDS information as necessary, ensures recordation of social services matters in progress notes.
Performs quality assessment and assurance functions, including but not limited to: daily regulatory compliance rounds; observation of provision of social services, record reviews; implementation of corrective measures, staff members, residents, family interviews.
Assists with development and updating social services policies and procedures to reflect the philosophy of the facility, professional standards, and legal requirements.
Participates with Executive Director/designee in survey processes by: instructing staff regarding conduct and disclosure, reporting, being present at all times surveyors are on-site, directing prompt responses to requests for information, and undertaking corrective action, if appropriate.
Maintains and applies current skills and knowledge through continuing education and in-service programs.
Carries out responsibilities in compliance with federal, state, local laws and regulations and in-service programs.
In an emergency, carries out assigned duties to assure resident and employee safety.
Excellent interpersonal skills with high level of energy and enthusiasm. Ability to organize, document, and implement detailed programs.
Good verbal and written communications.
Maintains and applies current skills and knowledge through continuing education and in-service programs.
This position requires standing, sitting, stooping, pushing, pulling, lifting up to 25 pounds or more, bending, climbing, twisting upper body, walking, running, carrying, listening, talking, use of telephone, and exposure to medical equipment and persons with risk of illness.
SUPERVISORY RESPONSIBILITIES: Directly supervises employees and carries out supervisory responsibilities in accordance with the facility policies, practices, procedures, and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Must consistently use discretion and independent judgment.

EDUCATION and/or EXPERIENCE: High school diploma or general education degree (GED). Two to four years related experience and/or training or equivalent combination of education and experience. Previous social services experience in a health care setting preferred. Must have a Bachelor's degree in Social Work or related field. Meets state and federal requirements..

CERTIFICATES, LICENSES, REGISTRATIONS: Driver’s license per facility requirements preferred.