Clinical Navigator (Exempt) - Victoria Rehab
Company: PAM Health
Posted on: January 5, 2022
Clinical NavigatorThis position works under the direction of the
Director of Business Development. Cultivates referral
relationships, manages assigned territory, and completes patient
assessments. Makes sales contacts as well as analysis of referral
and admission data from assigned territory. Works collaboratively
with business development team members including the Admissions
Manager and admission staff, as well as nursing and other internal
and external staff to facilitate the referral conversion. Provides
feedback and recommendations for program development and quality
improvement initiatives related to customer service, the referral
and admission process and patient and referral source satisfaction.
Develops and maintains excellent relationships to all stakeholders
including prospective patient, family members, physicians, ICU and
floor nurses, discharge planners, case managers and payer
representatives. Performs other related duties as assigned or
- Maintains responsibility for patient referral until patient
admits to Post Acute Medical.
- Displays knowledge of both inpatient rehabilitation and
long-term acute care (LTACH) admissions criteria for pre-assessment
- Coordinates and completes on-site pre-admission assessments on
potential patients unless geographically prohibitive or competitive
time of admission will not allow. In the assigned market uses the
fast track process to facilitate referral conversions. Completes
phone/FAX assessments if geographically prohibitive. Documents
pre-admission assessments legibly, accurately, and completely in
the approved format.
- Reviews medical record of referred patient and identifies all
aspects related to pre-certification financial coverage and
admission criteria. Serves as a navigator to the Admissions office
for insurance companies and provides clinical information to obtain
pre-certification from payers.
- After reviewing medical record and interviewing patient/family,
obtains facility admission information to support the admission
process; makes a recommendation regarding acceptance and level of
care, and communicates status of admission to referral source as
directed by the admissions department.
- Orients patient and/or family to facility services, including
length of stay. Educates supports and serves as a resource to
family members of current, past and potential patients.
- Communicates with facility Admissions department and facility
CEO on a daily basis to optimize census management and case finding
- Follows up on all pending as well as medical denials in person
to re-evaluate potential for admission.
- Conducts follow up with referral facilities to ensure
satisfaction and service levels were met.Business Development
- Designs and manages the marketing strategies for their assigned
- Uses sales and marketing techniques to show growth in admission
and revenue volume.
- Creates Quarterly Business Development Plan for their assigned
- Utilizes educational opportunities to present the hospital to
- Identifies contacts and manages potential referral sources
using account management system.
- Uses prospecting methods to generate leads.
- Meet the referral and admission goals for their assigned
- Participates in community events/activities.
- Attends weekly Business Development meetings.Education
- Identifies and educates new referral sources to Post Acute
Medical programs and services.
- Assesses and conveys stakeholder needs. Establishes and
maintains strong relationships with providers through ongoing
assessment and servicing of their client's rehabilitation/LTACH
- Schedules educational inservices to educate referral services
about Post Acute Medical programs and services; works closely with
the Admissions department and Director of Business Development to
achieve targeted census goals and meet assigned objectives on a
weekly, monthly and quarterly basis. Communicates clearly,
concisely and accurately.
- Provides or arranges educational presentations to referral
sources (physicians, discharge planners), families and to community
members as requested.
- Coordinates and schedules professional, family and/or potential
patient tours of all facilities.
- Gathers information on health care providers in the facility
service area and forwards to management, including opportunities
for contracting with managed care companies and providers.
- Assists in the development of new programs and services through
ongoing assessment of the needs of professionals, families, and
- Remains current on new programs and services in the Post Acute
Medical System through frequent communication and facility
- Effectively maintains log of all pending cases.
- Provides periodic verbal/telephone/email update on activities
and market trends as requested.
- Maintains a resource library of articles and information for
distribution to professionals, community members, families and
potential patients to assist them in understanding facility
services and the various disability groups served.
- Completes a quarterly plan for assigned territory.
- Maintains territory Account Management
System.QUALIFICATIONSEducation and Training: Degree from an
accredited college or university in a health field, preferably
nursing. Current licensure in nursing or respiratory therapy is
preferred. Prior marketing and/or rehabilitation/LTACH experience
preferred.Experience: Must have a minimum of two years' experience
in the designated field of license, preferably with
rehabilitation/LTACH and marketing experience.Knowledge, Skills,
- Excellent clinical and assessment skills.
- Effective presentation and training skills.
- Excellent written and oral communication skills.
- Effective crisis management skills, with demonstrated
facilitation and problem solving experience.
- Effective team leadership skills.
- Knowledge of PPS payment/reimbursement systems and DRG's/case
- Knowledge of patient rights and commitment to patient
- Ability to collect, document, and analyze data.
- Word processing and data entry skills.
- Network access to community, state, and national resources and
health services organizations.
- Excellent relationship management skills with referral sources
and physicians.ABOUT USPAM Health is committed to being the most
trusted source for post-acute services in every community it serves
by utilizing experienced and dedicated staff to provide high
quality patient care and customer service. With over 44 Long Term
Acute Care and Rehabilitation hospitals and 16 Outpatient Clinics
currently in operation across the country, we are proud to offer
services including comprehensive wound care, aquatic therapy,
ventilator weaning, amputation treatment, pain management and much
more.Joining our PAMily allows you to work in a collaborative
environment with colleagues and leadership with exposure to a
variety of patient care levels. Aside from our competitive pay,
generous paid benefit time, and excellent insurance options, you
will also have opportunities for professional growth through our
Education Advancement Program.We are excited to learn more about
you and hope that you consider joining us on a shared mission to
improve the lives of others by being an integral part of our We
Care Program. Please take a moment to visit us online at
www.postacutemedical.com for a comprehensive look at how we're able
to positively impact our local communities.PAM Health does not
discriminate and does not permit discrimination, including, without
limitation, bullying, abuse or harassment, on the basis of actual
or perceived race, color, religion, national origin, ancestry, age,
gender, physical or mental disability, sexual orientation, gender
identity or expression or HIV status, or based on association with
another person on account of that person's actual or perceived
race, color, religion, national origin, ancestry, age, gender,
physical or mental disability, sexual orientation, gender identity
or expression or HIV status.Licenses & CertificationsPreferred
- Registered Nurse
- Respiratory Care Pract
Keywords: PAM Health, Victoria , Clinical Navigator (Exempt) - Victoria Rehab, Healthcare , Victoria, Texas
Didn't find what you're looking for? Search again!