Franciscan Missionaries of Our Lady Health System
Rehabilitation Liaison PRN
Franciscan Missionaries of Our Lady Health System, Baton Rouge, Louisiana, United States, 70808
Job Description
1. Evaluates potential rehab candidates referred to OLOL Rehabilitation Center and functions as a liaison between OLOL and referral sources. Pre-admission assessments are conducted under the criteria and guidelines of CMSs IRF-PPS to ensure appropriateness of admission and to determine medical necessity. 2. Works with healthcare team to develop rehab treatment/discharge plan. 3. Conducts weekly Admissions Committee meetings with Medical Director to determine appropriate admissions and communicates information to nursing team. 4. Maintains archives of denied patient assessments for the required period. 5. Develops, builds, and maintains professional relationships with current or potential referral sources. Understands the capabilities of outside referral sources (such as home health, skilled nursing, etc) and the requirements for prior approval by payors for admission, continued stay, and discharge. 6. Contributes to community and professional education. Assists with marketing efforts and customer satisfaction to ensure continuation and/or expansion of referral base. Participates in SPIRIT classes as requested to explain inpatient rehab, the referral process, rehab qualifications and expectations. 7. Obtains timely pre-certification and insurance verifications from third-party payors to support effective reimbursement for admissions. Uses 3M and RUMBA programs to verify and document insurance information. Serves as liaison with HCR office for Medicaid applicants. Communicates with business office when insurance changes occur. Communicates insurance/payor information to patients and families. 8. Understands IRF-PPS regulatory criteria and how to access resource information from CMS, MACs, etc. in order to maintain optimum reimbursement for the unit. Initiates and completes the IRF-PAI. Demonstrates ability to maximize financial outcomes with effective coding of the IRF-PAI. 9. Collaborates with HIM and physicians to ensure appropriate capture of coding that supports medical necessity criteria. Communicates CMG information to the interdisciplinary team in order to facilitate care planning. 10. Communicates approval status with referral sources, patients and families in a timely and effective manner. Interacts with team members to facilitate alternate placement in the event of denial or inability to admit to OLOL Rehabilitation Center. 11. Communicates information with patients and families about the rehab physician, expectations of the inpatient program, discharge planning, family training, and team conferences. Provides tours of the unit upon request. 12. Demonstrates ability to access and utilize community resources. Is knowledgeable of ADA and other federal guidelines that support individuals with disabilities. Appropriately refers patients/families to community resources for additional support. 13. Other duties as assigned.
Experience - Three years in general or specialty practice Education - Associate's Degree Licensure - Current Unrestricted Louisiana RN license (if nurse), Current Unrestricted Louisiana LPN license or Current Louisiana Therapy license (if PT/OT/ST, certification also required if ST) or Licensed Physical Therapy Assistant.
About Us
The Franciscan Missionaries of Our Lady Health System is a leading health care innovator in Louisiana and Mississippi. We bring together outstanding clinicians, the most advanced technology and leading research to ensure that our patients receive the highest quality and safest care possible.
This commitment is grounded in a history that is more than 100 years old, but reflected today by our strategic vision of transforming healthcare through superior performance and excellent patient care. In the last fiscal year, Franciscan Missionaries of Our Lady Health System had: 1,747 Licensed Beds 65,322 Discharges 44,592 OR Procedures 10,827 Full Time Employees 331,360 Inpatient Days 1,915 Active Medical Staff 229,296 Emergency Visits
As a nonprofit, mission-focused Catholic healthcare ministry, we give special attention to our citizens who are most in need. During the most recent fiscal year, we provided more than $39 million in unreimbursed care and community support to the underprivileged.
Our health system is one of the largest in Louisiana, with hospitals, clinics and physicians located throughout Louisiana and in Mississippi. In fact, we provide care to almost half of Louisiana's citizens, and serve in Mississippi's largest metropolitan area. Because of our size and the partnerships we have with other local organizations, we are able to pool our resources and share cost and service efficiencies and learn from each other, thereby accelerating our ability to improve care and solve challenges.
Since our founding in Monroe, Louisiana in 1911, we have been blessed by the guidance of the Franciscan Sisters. Through their guidance and steadfast example, we have committed to assure that we perpetuate their healing ministry for another hundred years. It is a noble purpose we strive to fulfill every day.
Headquartered in Baton Rouge, Louisiana, we serve patients across Louisiana and Mississippi through a network of hospitals, clinics, physicians, elderly housing and integrated information system. Our health system has partnered with the State of Louisiana as it transforms its healthcare delivery system. The partnership includes inpatient acute care and primary care delivery in Baton Rouge and Bogalusa.
Following in the footsteps of our founders, the Franciscan Missionaries of Our Lady, our team members and physicians are called to provide high quality care and compassion to all people, especially those most in need.
As we look to the future of our healthcare ministry, we chart our course by "going where we are called."
1. Evaluates potential rehab candidates referred to OLOL Rehabilitation Center and functions as a liaison between OLOL and referral sources. Pre-admission assessments are conducted under the criteria and guidelines of CMSs IRF-PPS to ensure appropriateness of admission and to determine medical necessity. 2. Works with healthcare team to develop rehab treatment/discharge plan. 3. Conducts weekly Admissions Committee meetings with Medical Director to determine appropriate admissions and communicates information to nursing team. 4. Maintains archives of denied patient assessments for the required period. 5. Develops, builds, and maintains professional relationships with current or potential referral sources. Understands the capabilities of outside referral sources (such as home health, skilled nursing, etc) and the requirements for prior approval by payors for admission, continued stay, and discharge. 6. Contributes to community and professional education. Assists with marketing efforts and customer satisfaction to ensure continuation and/or expansion of referral base. Participates in SPIRIT classes as requested to explain inpatient rehab, the referral process, rehab qualifications and expectations. 7. Obtains timely pre-certification and insurance verifications from third-party payors to support effective reimbursement for admissions. Uses 3M and RUMBA programs to verify and document insurance information. Serves as liaison with HCR office for Medicaid applicants. Communicates with business office when insurance changes occur. Communicates insurance/payor information to patients and families. 8. Understands IRF-PPS regulatory criteria and how to access resource information from CMS, MACs, etc. in order to maintain optimum reimbursement for the unit. Initiates and completes the IRF-PAI. Demonstrates ability to maximize financial outcomes with effective coding of the IRF-PAI. 9. Collaborates with HIM and physicians to ensure appropriate capture of coding that supports medical necessity criteria. Communicates CMG information to the interdisciplinary team in order to facilitate care planning. 10. Communicates approval status with referral sources, patients and families in a timely and effective manner. Interacts with team members to facilitate alternate placement in the event of denial or inability to admit to OLOL Rehabilitation Center. 11. Communicates information with patients and families about the rehab physician, expectations of the inpatient program, discharge planning, family training, and team conferences. Provides tours of the unit upon request. 12. Demonstrates ability to access and utilize community resources. Is knowledgeable of ADA and other federal guidelines that support individuals with disabilities. Appropriately refers patients/families to community resources for additional support. 13. Other duties as assigned.
Experience - Three years in general or specialty practice Education - Associate's Degree Licensure - Current Unrestricted Louisiana RN license (if nurse), Current Unrestricted Louisiana LPN license or Current Louisiana Therapy license (if PT/OT/ST, certification also required if ST) or Licensed Physical Therapy Assistant.
About Us
The Franciscan Missionaries of Our Lady Health System is a leading health care innovator in Louisiana and Mississippi. We bring together outstanding clinicians, the most advanced technology and leading research to ensure that our patients receive the highest quality and safest care possible.
This commitment is grounded in a history that is more than 100 years old, but reflected today by our strategic vision of transforming healthcare through superior performance and excellent patient care. In the last fiscal year, Franciscan Missionaries of Our Lady Health System had: 1,747 Licensed Beds 65,322 Discharges 44,592 OR Procedures 10,827 Full Time Employees 331,360 Inpatient Days 1,915 Active Medical Staff 229,296 Emergency Visits
As a nonprofit, mission-focused Catholic healthcare ministry, we give special attention to our citizens who are most in need. During the most recent fiscal year, we provided more than $39 million in unreimbursed care and community support to the underprivileged.
Our health system is one of the largest in Louisiana, with hospitals, clinics and physicians located throughout Louisiana and in Mississippi. In fact, we provide care to almost half of Louisiana's citizens, and serve in Mississippi's largest metropolitan area. Because of our size and the partnerships we have with other local organizations, we are able to pool our resources and share cost and service efficiencies and learn from each other, thereby accelerating our ability to improve care and solve challenges.
Since our founding in Monroe, Louisiana in 1911, we have been blessed by the guidance of the Franciscan Sisters. Through their guidance and steadfast example, we have committed to assure that we perpetuate their healing ministry for another hundred years. It is a noble purpose we strive to fulfill every day.
Headquartered in Baton Rouge, Louisiana, we serve patients across Louisiana and Mississippi through a network of hospitals, clinics, physicians, elderly housing and integrated information system. Our health system has partnered with the State of Louisiana as it transforms its healthcare delivery system. The partnership includes inpatient acute care and primary care delivery in Baton Rouge and Bogalusa.
Following in the footsteps of our founders, the Franciscan Missionaries of Our Lady, our team members and physicians are called to provide high quality care and compassion to all people, especially those most in need.
As we look to the future of our healthcare ministry, we chart our course by "going where we are called."