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Posted Jan 27
NCPHS Northern California Presbyterian Homes and Services

ADMISSION CARE COORDINATOR

San Francisco, CA, United States Full Time
Salary: Depends upon experience.
Reference: NCPHS-JD-020617

ADMISSION CARE COORDINATOR JOB SUMMARY:
Is the designee that manages the referral and assessment process for admissions into NCPHS skilled nursing facilities. Determines patient eligibility for admission by reviewing inquiries inclusive of initial criteria and financial reviews of payment sources. Coordinates and ensures prompt information flow from hospital to skilled nursing facility staff.

ESSENTIAL FUNCTIONS:

  • Monitors all community bed availabilities and works with Director of Health Services Marketing, Directors of Nursing Services and CCRC Health Center staff.
  • Receives and manages all referrals, including those from Curaspan and Allscripts, for the three NCPHS skilled nursing facilities. Documents initial assessment within 30 minutes of receipt of referral.
  • Obtains required information on potential admissions, including working directly with acute case managers, individuals and insurance providers. Obtains initial billing information, including Medicare common working files and HMO authorization.
  • Conducts initial health status review to determine if patient meets skilled nursing admission criteria using the green to go criteria per community.
  • Completes a comprehensive review from medical records received. Identifies problems or opportunities that would need to be addressed in the plan of care. This may include; type of care, , language or cultural barriers, current condition(s) or functional limitations, specialized DME, lack of support system or presence of a support system under stress, financial barriers, compromised patient safety and discharge plan.
  • Reviews patient’s records to collect data to carefully understand the needs of the patient by scrutinizing their background history, understanding their current needs, and arranging for their well-being. Evaluates patient’s overall risk and determines if patient meets criteria for admission.
  • Using NCPHS admission policy and procedure guidelines assesses appropriateness of CCRC skilled nursing admission, level of care, and length of stay.
  • Confirms Medicare and HMO managed care eligibility and obtains pre-authorization for payment. Sends Health Center Financial Authorization form to responsible party for completion to ensure patient is financially qualified for admission.
  • Sends referral, clinical chart and pre-admission information to the appropriate NCPHS SNF contact for review and clinical decision.
  • Coordinates with other disciplines to facilitate the patient’s individual care needs and determine appropriate facility. Anticipates and identifies variances in the care process related to those identified needs.
  • Supports all community residents that are discharged to a higher level of care by coordinating with the case manager to ensure care needs are met and continuity of care is reflected in the return to the community.
  • Upon community acceptance or denial of admission, records primary decision for the purpose of reporting and tracking of admissions and discharges. Tracks admission, skilled nursing facility stay, and discharge data in a dashboard and communicates the data internally and to third party referral sources.
  • Maintains admission data collection to include referral MD’s consulting MD’s, readmission components and community resources involved with the placement.
  • Coordinates transportation between discharge and NCPHS skilled nursing facility admission location.
  • Performs other work as assigned.


HOME OFFICE CORE COMPETENCIES REQUIRED:

Administration/Business Management – Acts appropriately within company and department; demonstrates cooperative spirit, respects the rights and abilities of others; begins work on time; supports the NCPHS Mission, Core Values, decisions and initiatives of the organization; manages competing demands on time and remains focused on key objectives.

Customer Service (includes residents, internal customers/staff and vendors) – Determines the customers’ needs and wants; demonstrates high commitment to customers; analyzes problems from different points of view; draws accurate conclusions from quantitative information.

Communication/Interpersonal Skills – Produces exceptional written materials; speaks fluent English; listens closely to others; brings conflict into the open and attempts to resolve it; demonstrates a positive attitude; exhibits patience and understanding; maintains composure; exhibits good judgment, maintains confidentiality and is considerate in all dealings with others.

Technical: Job Knowledge, Current Technology – Understands all job functions and responsibilities; understands capabilities and uses of applicable NCPHS systems to manage workload; demonstrates knowledge and adherence to NCPHS Corporate Compliance and safely conducts work tasks, keeping in compliance with Safety Programs.

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED TO PERFORM ESSENTIAL JOB FUNCTIONS:

Interpersonal skills to establish and maintain good working relationships among hospital case managers, unit personnel, other department personnel and CCRC clinical staff. Sensitivity and understanding of issues related to aging. Thorough knowledge of current nursing theory and practice. Familiarity and ability to act in accordance with corporate compliance and quality assurance and performance improvement programs. Knowledge of and ability to navigate Medicare, HMO, PPO plans and pre-screening of all community referrals. The ability to perform work that may require sitting, walking, stooping, bending and lifting up to 50 pounds. Ability to use a keyboard, mouse, and view a computer monitor. Ability to start work on time according to a schedule.

QUALIFICATIONS:

Graduated from an accredited four year university or college. Two to four years’ recent experience working in a skilled nursing facility, assisted living facility or CCRC. Experience and working knowledge of Medicare, electronic health record software, and the Microsoft Office suite of products including Word and Excel. Must read, write, understand, and speak English fluently.

REPORTS TO: Director Health Services Marketing

NCPHS is an Equal Opportunity Employer. In compliance with the Americans with Disabilities Act, NCPHS will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective employees and incumbents to discuss potential accommodations with the employer.

Additional Application Instructions

Fax resume to: 415-351-7963

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