naviHealth is the result of over a decade of dedicated visionary leaders and innovative organizations challenging the status quo for PAC management solutions. We do healthcare differently and we are changing healthcare one patient at a time. How might you ask? By hiring talented clinicians, engineers, developers, and healthcare leaders to create and utilize cutting edge technology in order to provide the patient with the best level of care for the right amount of time.
Why Is This Role Critical?
The Skilled Inpatient Care Coordinator (SICC) plays an integral role in optimizing the patient’s recovery journey. The SICC completes weekly LiveSafe assessments and engages the PAC inter-disciplinary care team providing them with the Outcomes Prediction Tool (OPT) to align expectations for discharge planning. He/She will engage the patient and family to share information and facilitate informed decisions. By serving as the link between patients and the appropriate health care personnel, the SICC is responsible for ensuring efficient, smooth, and prompt transitions of care.
What you will be accountable for….
- Perform SNF assessments on patient using clinical skills and appropriate measurement tools such as LiveSafe, OPT, InterQual and CMS criteria upon admission to SNF and periodically through the patient’s stay
- Review targets for LOS, target outcomes and discharge plans with the providers and family
- Completes all SNF concurrent reviews, updating Authorizations on a timely basis
- Collaborate effectively with the patient’s health care team to establish an optimal discharge plan. The health care team includes physicians, referral coordinators, discharge planners, social workers, physical therapist, etc.
- Assure the patient is progressing toward discharge goals and assist to resolve barriers
- Participate in SNF Rounds weekly providing accurate and up to date information to the naviHealth Sr. Manager or Medical Director
- Assure appropriate referrals are made to the Health Plan, High Risk Case Manager and/or community-based services
- Engages with patient, family or caregiver either telephonically or on-site weekly and as needed
- Attends the patient/family care conference
- Assess and monitor patient’s continued appropriateness for SNF setting (as indicated) according to InterQual criteria or the OPT
- When naviHealth is delegated for utilization management review refer requests that cannot be approved for continued stay and are forwarded to licensed physicians for review and issuance of the NOMNC when appropriate
- Coordinate peer to peer reviews with naviHealth Medical Directors
- Supports new delegated contract start up to ensure experienced staff work with new contract
- Manage assigned caseload in an efficient and effective manner utilizing time management skills
- Enter timely and accurate documentation into the CM Tool application
- Daily review of census and identification of barriers to manage independent workload and ability to assist others
- Review with the assigned Clinical Team Manager monthly dashboards, readmission reports, quarterly and other reports as needed to assist with the identification of opportunities for improvement
- Adhere to organizational and departmental policies and procedures.
- Maintains confidentiality of all PHI information in compliance with HIPPA, federal and state regulations and laws
What you will need to be successful in this role….
- Registered Clinician is a requirement of the role with preference for RN, PT, or OT credentials
- Current active unrestricted clinical license required
- 3-5 years of clinical experience required
- Experience working with geriatric population preferred
- Exceptional interpersonal and communication skills
- Strong problem solving, conflict resolution and negotiating skills
- Proficient with Microsoft Office applications including Word, Excel and Power Point
- Independent problem identification/resolution and decision making skills
- Detail oriented
- Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously
- Team player
- Ability to travel in a local or regional market depending upon facility alignment
- Ability to establish a home office work space
- Bachelor’s degree preferred
- Case Management experience with CCM preferred
- Patient education background, rehabilitation and/or home health nursing experience a plus
NaviHealth is a pioneer in care transitions with a combined unprecedented 16 years of experience that uniquely positions us to manage and share risk with our partners. As a Cardinal Health company, we provide clinical support alongside scaled technology and advisory solutions that empower health systems, health plans, and post acute providers to navigate care episodes across the continuum, with the goal of reducing waste and improving patient outcomes
naviHealth ™ is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce