Clinical Liaison

Position Type : Clinical Liaison (Full Time)

As the job title implies, a Clinical Liaison plays a vital role in building and maintaining relationships between healthcare providers, patients, families, and skilled nursing facilities. This position involves coordinating admissions, educating patients and providers, verifying insurance, and promoting the facility’s services throughout the community.

The ideal candidate will have a clinical background, strong communication skills, and a passion for advocating for patient-centered care.

Essential Duties and Responsibilities of a Clinical Liaison :

Conduct pre-admission assessments to gather clinical and financial documentation for quick response to referrals.

Collaborate with hospital discharge planners to identify and prioritize patient transitions to skilled nursing care.

Build and maintain strong relationships with hospital case managers, physicians, and managed care organizations.

Educate hospital staff, including ER physicians, on the facility’s clinical capabilities and appropriate referral criteria.

Meet with patients and families to explain services, care options, and address questions or concerns prior to admission.

Identify patients’ special needs (equipment, medications, services) and ensure the facility can meet those needs before admission.

Coordinate with nurse managers to ensure training is in place for the care of high-risk patients.

Complete bedside assessments for risk identification and initiate care plans.

Maintain compliance with all federal and state regulations, including HIPAA and confidentiality laws.

Verify health insurance eligibility and gather benefits information.

Review clinical documentation to support insurance authorization requirements.

Submit prior authorizations with appropriate codes (CPT, ICD-10) and supporting documentation; manage appeals as needed.

Serve as a liaison between patients, providers, and insurers to ensure understanding of financial responsibilities.

Identify opportunities for growth by promoting new services, targeting specific populations, and expanding partnerships.

Represent the facility at community events and schedule speaking engagements.

Work with the marketing team to enhance community awareness of the facility’s services and competitive advantages.

Required Knowledge, Skills and Abilities :

Bachelor's degree or equivalent experience required.

Clinical or nursing background is required; experience in discharge planning, case management, or utilization review is strongly preferred.

Experience in the healthcare industry, specifically in acute care or skilled nursing environments.

Strong understanding of medical terminology, coding, and insurance authorization processes.

Knowledge of electronic health records and healthcare databases.

Excellent verbal and written communication skills.

Strong interpersonal, organizational, and multitasking abilities.

Customer-service oriented with a professional, respectful, and positive demeanor.

Familiarity with local hospitals, physicians, and referral sources is highly desirable.

EQUAL OPPORTUNITY EMPLOYER

The Facility is an equal opportunity employer. The Facility does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Facility will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Facility, including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.