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Referral Center Registered Nurse- Home Care

North Shore-LIJ Health System Type Full time Posted 5/10/2014
Salary - n/a - Starts 7/23/2014
NY - New York (All) - Westbury Referral - n/a -    
Referral Center Registered Nurse- Home Care
Description

Reviews patient referrals made to the North Shore-LIJ Home Care Network for clinical appropriateness.  Facilitates the flow of new referral information to ensure timely provision of home care services.  Assists with insurance inquiries and obtaining authorization for services.  

 
 

 

 

Reviews home care referrals from all sources.
  • Utilizes knowledge of home health services and regulations to ensure referrals have all necessary clinical components.
  • Identifies services, disciplines and appropriate clinical specialty program for referral.
  • Verifies active/current physician license information.
  • Facilitates insurance authorizations for home care service.
  • Reviews referral for completeness of clinical and demographic information.
  • Processes referral to initiate services.
2.  Educates the community/referral sources on home care services.
  • Explains home care guidelines for Medicare, Medicaid, and all other payor sources.
  • Explains the types of home care providers, i.e., CHHA, MLTCP, and licensed.
  • Assists in identifying type of home care service they need by asking pertinent questions about the patient’s diagnosis and health care needs and available caregiver resources.
3.  Functions as an integral part of the Home Care Team by expanding   theoretical knowledge base, improving clinical techniques, and enhancing interpersonal skills.
  • Demonstrates current and in-depth knowledge of clinical practice and available community resources, differentiating varying levels of care needs.
  • Demonstrates the ability to make decisions based on sound judgment. 
  • Acts as a role model for Home Care team members, students, patients and families.
  • Participates in Performance Improvement and Utilization Review activities within Home Care Network.
  • Contributes pertinent information via participation in staff meetings, conferences and other activities when appropriate.
  • Establishes and maintains effective working relationships with patients, families and professional associates.
  • Demonstrates current knowledge of professional and general health care issues.
  • Seeks information and knowledge to enhance level of expertise.
  • Shares information learned with peers.
  • Assists with providing orientation to new nursing personnel on policies, procedures and practices.
4.  Functions as an essential part of the Referral Center Team.
  • Facilitates the information/paper flow of referrals to ensure timely provision of home care services.
  • Assists with insurance inquiries and authorizations.
5.  Performs job functions in a fiscally responsible manner consistent with the Agency’s mission and vision.
  • Utilizes sound time management skills in planning day-to-day activities and fulfilling job duties.
  • Demonstrates appropriate and efficient use of supplies and equipment.
  • Consistently meets the productivity standard established by the Home Care Network.
6.  Performs related duties, as required.
 

*ADA Essential Functions

 


Qualifications
·         Bachelor’s Degree in Nursing, preferred.
·         Licensed to practice as a Registered Professional Nurse in New York State. 
·         Minimum of one (1) year of medical/surgical nursing experience and one (1) year of Home Care experience. 
Basic computer skills.