Transition of Care Specialist

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 facilitys practices related to all pay status types such as other insurances Medicare A Medicaid Private Veterans Administration contracts and hospital contracts etc.

May at times be required to complete mental health screenings as required by federal and state regulations prior to admission.

Assists with processing referrals timely on a daily basis as assigned by the Administrator/Regional Director of Business Development.

Ensures residents are admitted transferred and discharged from the facility software accurately on a daily basis.

Records resident pay status changes on the facilitys internal daily census communication tool.

Records resident pay status accurately in the residents record at time of admission and at time.

Behaves in a manner aligned with facility goals for occupancy and customer service.

Meets with potential residents/representatives daily and provides information about the facility.

Provides tours of the facility daily shares mission vision and values with potential patients and educates on facility services as well as RMC continuum of care.

Works in a helpful and pleasant manner daily using the telephone to communicate with families residents hospitals insurance companies etc. related to processing referrals.

Works numerous times a day using a computer electronic medical record spreadsheets and other tools related to processing referrals.

Completes admission paperwork and files according to facility policy.

Informs the Administrator/Regional Director of Business Development of obstacles or barriers to admitting residents.

Maintains daily referral tracking information as assigned by the Administrator/Regional Director of Business Development.

Communicates with interdisciplinary team members timely regarding room assignments for pending admissions.

Demonstrates interpersonal relationship skills by developing and maintaining trust with coworkers.

Completes the daily census for the facility as well as the daily census/status for RMC transitions of care.

Participates in facility assessment activities as needed such as carrying out duties assigned as part of a performance improvement committee.

Collaborates with members of the interdisciplinary team family members hospitals and community a manner that resolves issues and improves the admissions process.

Promotes teamwork mutual respect and effective communication.

Participates in the facilitys plan of correction response to an inspection survey and implements any follow-up as designated by the Administrator.

Promotes safe work practices safety rules and accident prevention procedures to prevent employee injury and illness.

Additional Tasks

1. Treats all residents with dignity and respect. Promotes and protects all residents rights.
2. Establishes a culture of compliance by adhering to all facility policies and procedures. Complies with standards of business conduct and state/federal regulations and guidelines.
3. Follows appropriate safety and hygiene measures at all times to protect residents and themselves.
4. Maintains confidentiality of protected health information including verbal written and electronic communications.
5. Reports noncompliance with policies procedures regulations or breaches in confidentiality to appropriate personnel. Reports any retaliation or discrimination to HR or compliance officer.
6. Reports any allegations of abuse neglect misappropriation of property exploitation or mistreatment of residents to supervisor and/or administrator. Protects residents from abuse and cooperates with all investigations.
7. Reports any occupational exposures to blood body fluids infectious materials and/or hazardous chemicals in accordance with facility policy.
8. Participates in all life safety and emergency drills and trainings. Fulfills responsibilities as assigned during implementation or activation of the facilitys emergency plan.
9. Reports work-related injuries and illnesses immediately to supervisor.
10. As a condition of employment completes all assigned training and skills competency.
11. Follows established infection control policies and procedures.

Personal Skills and Traits Desired/ Physical Requirements/Working Conditions

1. Ability to read write speak and understand the English language.
2. Must be a supportive team member contribute to and be an example of team work.
3. Ability to make independent decisions when circumstances warrant such action.
4. Ability to deal tactfully with personnel residents family members visitors government agencies/personnel and the general public.
5. Must have patience tact and willingness to deal with difficult residents family and staff.
6. Must be able to relay information concerning a residents condition.
7. Must not pose a threat to the health and safety of other individuals in the workplace.
8. Must be able to move intermittently throughout the workday.
9. Meets general health requirements according to facility policy including medical and physical exams and checking immunity status to various infectious diseases.
10. Ability to work beyond normal working hours and on weekends and holidays when necessary.
11. Ability to assist in evacuation of residents during emergency situations.
12. Ability to bend stoop kneel crouch perform overhead lifting and perform other common physical movements as needed for the position.
13. May be subject to falls burns from equipment and/or odors throughout the day; encounter reactions from dust tobacco smoke disinfectants and other air contaminants.
14. Subject to exposure to infectious waste diseases and/or conditions which include AIDS Coronavirus Hepatitis B and Tuberculosis.
15. May be subject to hostile or emotional residents family members visitors or personnel.
16. Works in office and throughout the facility.
17. Willing to work to task completion in spite of frequent interruptions.
18. Subject to hostile and emotionally upset residents family member personnel and visitors.
19. Works beyond normal working hours and on weekends holidays when necessary. On call 24 hours per day 7 days per week.

Compliance as a Condition of Employment and Performance Appraisal

Agreement to abide by all standards policies and procedures of the facility including the facilitys compliance and ethics program is a condition of employment. Compliance will be a factor in evaluating job performance. Violations including failure to report violations will result in disciplinary action up to and including termination.

This job description is intended to convey the general scope of the major duties and responsibilities inherent in this position. Other tasks not listed here may be assigned by the Administrator. Periodic revision may be necessary to reflect changes in expectations placed on long term care by various governmental agencies. This job description will be reviewed and/or revised annually and as needed.

Individual performance will be evaluated using the following scale:

1. Unsatisfactory: Achieves results which are far less than the standards identified for the performance factors rated.
2. Needs Improvement: Achieves results which are less than the standards identified for the performance factors rated. Exhibits the potential to become a competent performer. May be new to job or need skill development.
3. Meets Standards: Achieves results which meet the standards identified for the performance factors rated. This rating is the expected level of performance.
4. Exceeds Standards: Achieves results which usually exceed the standards identified for the performance factors rated.

Reasonable Accommodation Statement

Consistent with the Americans with Disabilities Act (ADA) and insert state civil rights law it is the policy of Rocky Mountain Care to provide reasonable accommodation when requested by a qualified applicant or employee with a disability unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment including the application process. If reasonable accommodation is needed please contact Human Resources at or by email .