Senior Nurse Navigator - Pensacola

JOB PURPOSE:

Nurse Liaison will function as a facilitator to hospitals and community services in need of referring to our organization. Assists in the evaluation of patients to ensure that they are appropriate for admission to the home health or hospice agency.  Provides clinical expertise to our home health and hospice agencies by evaluating their ability to meet the patient’s clinical needs.  In addition, this individual is a sales professional who focuses on the development of early and appropriate referrals by creating and sustaining business partnerships with facilities and hospitals.

KEY RESPONSIBILITIES:

1. Fluent with all regulatory agencies, reimbursement systems and levels of care.

2. Must be knowledgeable of private insurance, Medicare and Medicaid coverage criteria, rules and regulations and reimbursement methodologies. 

3. Taking responsibility for a regional territory of hospitals and community services in order to facilitate the placement of patients within the Pruitt Health continuum.

4. Duties include taking call for discharge planners in need of assistance, providing on site clinical assessments, completing necessary discharge paperwork, communicating referral needs within our continuum and facilitating admissions into the Pruitt Health network.

5. Must provide excellent customer service to all referral sources and network of providers.

6. Represents organization in various community efforts and education seminars

7. Develops business relationships by making effective sales contacts and presentations.

8. Builds relationships with the PruittHealth Home Health/Hospice staff teams to ensure the establishment of effective communication with referral sources and the staff teams.

9. Communicates well with patients/residents/clients and family members providing warm and friendly greeting and an approachable attitude to families, visitors, patients/residents/clients and responds to expressed concerns while displaying a helpful, caring demeanor.  Answers questions when appropriate in a professional manner.

10. Reviews clinical, sales, and professional journals.

11. Reviews internal information, policies, publications, bulletins, etc.

12. Identifies territory assumptions which may influence the achievement of business goals.

13. Identifies key referring physicians.

14. Identifies key referring personnel in hospital, nursing homes, and other community facilities.

15. Communicates written plan to Vice President of Program Development and Community Relations Development Coordinator. Monitor, evaluate and adjust the plan as needed.

16. Completes call reports and documents daily activities

17. Develops plan for accounts management with input from staff teams.

18. Supports and participate in promotional activities.

19. Identifies existing relationships with competitive home health and hospice organizations, hospitals, nursing homes and physicians.

20. Develops, implements and evaluates quarterly and annual territory plans, strategies and actions to achieve negotiated goals.

21. Identifies case management, HMO, PPO, insurance companies and other payer referral sources.

22. Determines vulnerabilities of competitive relationships and set targets.

23. Joins and participates in appropriate organizations and associations.

24. Do