Transition of Care Specialist

Job Description

Department

Administration

Reports to

Director of Transitional Care /Dotted line to Admin

Reporting to this position

N/A

Job Classification

Business Development

Position Purpose

Growth and development of census and continuum of care services.  Completes day-to-day tasks regarding admissions, transitions to RMC continuum of care, marketing, and/or transfer of residents in accordance with local, state and federal standards and regulations, as well as established facility policies and procedures.

Required Qualifications

1. Demonstrates an understanding of arithmetic.
2. Must have, as a minimum, one (1) year of experience with demonstrated success in a position in the facility or in another related health care facility.
3. Knowledge of insurance coverage and authorization process pertaining to long-term care is helpful.
4. Knowledge and experience in working with multiple post-acute continuum of care services.
5. Demonstrates strong communication and people skills with the ability to market and grow facility census as well as RMC continuum care transitions.

Major Duties and Responsibilities

Participates in an open and collaborative relationship between the administrator, business development team, central intake, social work, business office and the admissions office, both working toward shared facility goals for occupancy and collections as well as continuum of care service growth. 

Perform duties daily in the admissions office as assigned by the Administrator/Regional Director of Business Development to facilitate the conversion of referrals to admission status and growth in transitions of care to RMC services.

Knows at all times, the status of each referral, both for the facility and for transitions of care. 

Communicates with external team members regarding referral status and any additional information needed to assist with the admission decision.

Communicates daily with RMC continuum of care team members to facilitate smooth transitions of care with each RMC service.

Communicates daily with the Business Office to complete financial evaluations for potential residents and payment options including but not limited to printing of the Common Working File, printing Medicaid Eligibility, and identifying the pay status with the resident/representative prior to admitting the resident.  

Works with external marketing team daily and participates in external marketing efforts  necessary to represent the facility and grow census.

Markets to and builds relationships with local hospital, provider groups and community members to educate on facility services and RMC continuum to grow facility census and RMC continuum of care.

Knows, at all times, which payment entities require prior authorization for payment and secures prior authorization when required for new admissions.

Maintains working knowledge of facility’s practices related to all pay status types such as other insurances, Medicare A, Medicaid, Private, Veteran’s Administration contracts, and hospital contracts, etc.

May at times be required to complete mental health screeni