Job description

JOB DESCRIPTION SUMMARY

Responsible for coordinating hospice services for managed care patients which includes establishing and maintaining the patient's plan of care, establishing and maintaining positive relationships with managed care customers and related referral sources, and negotiating service agreements

ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES

• Coordinates hospice services for managed care patients, assists with the establishment of the plan of care in coordination with the physician and insurance and ensures a seamless transition to hospice.
• Collaborates with inpatient utilization review departments and managed care organizations to facilitate safe, early inpatient discharge Verifies insurance coverage and obtains initial authorizations for services and seeks reauthorization for ongoing or additional services.
• Works with Clinical Supervisors/Nursing Supervisors and staff clinicians to gather, collate, and report patient care summary information to managed care Case Managers. Promotes maximum third party reimbursement through price negotiations with managed care organizations within the established financial, credit, and contractual parameters.
• Maintains comprehensive working knowledge of managed care contractual relationships and ensures that patients are admitted and services are delivered in accordance with contract provisions.
• Works with members of the billing team to ensure that managed care customers are billed according to managed care organization agreements.
• Establishes and maintains positive working relationships with current and potential managed care customers Promptly responds to managed care customer's requests and concerns.
• Maintains comprehensive working knowledge in the field of managed care and shares information with appropriate organization personnel.
• Maintains comprehensive working knowledge of community resources and assists customers in accessing community resources should services not be provided

POSITION QUALIFICATIONS

• Registered nurse with current licensure to practice professional nursing in the state Graduate of National League for Nursing accredited school of nursing. BSN degree is preferred.
• Complies with acceptable professional standards and practice.
• Ability to market aggressively and deal tactfully with customers and the community.
• Knowledge of corporate business management and managed care environment.
• Demonstrates good communications, negotiation, and public relations skills.
• Demonstrates autonomy, organization, assertiveness, flexibility and cooperation in performing job responsibilities.

Pay: $45.00 - $65.00 per hour

License/Certification:

• Driver's License (Required)

Work Location: On the road

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