Sales Marketer Director of Operation Healthcare, Clinical setting

JOB DESCRIPTION SUMMARY

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Responsible for all aspects of the patient intake process including coordinating with the members of the intake team, establishing and maintaining positive relationships with customers and referral sources, responding to customer requests and concerns, and managing the insurance verification and authorization processes.

ESSENTIAL JOB FUNCTIONS / RESPONSIBILITIES

• Evaluates hospitalized patients referred for home care.
• Attains a completed copy of the patient's history and physical.
• Identifies and verifies insurance coverage of home health care services.
• Obtains and documents prior authorization for home care services from insurance providers.
• Assists in obtaining supplemental managed care orders under the direction of the HMO Intake Manager.
• Negotiates per diem or per visit payment rates for creative bundling of home care services.
• Collaborates with the hospital's discharge planning personnel, utilization review department and insurance Case Managers to facilitate safe, early discharge.
• Consults with physicians, nurses, social workers, discharge planners and other disciplines to establish a coordinated home plan of care.
• Verifies the completion of a Face to Face.
• Interviews the patient, family, and caregiver and discusses the home situation, current needs, and any psychosocial factors that are relevant to the plan of care.
• Completes referral information that includes intake data, essential background information, hospital course, and the plan of care.
• Maintains liaison relationship with hospital and insurance personnel, providing information and education on Organization services, coverage issues and related areas.
• Participates in patient care conferences and in-services.
• Collects and maintains statistical data on all referrals and submits them regularly as required.
• Attends meetings and participates on committees as required.
• Informs Director of Patient Care Services and Intake Supervisor of all delays in clinical care.
• Performs other duties as assigned by the Administrator, Director of Patient Care Services, Director of Contract Management, and HMO Intake Supervisor.

POSITION QUALIFICATIONS

• Minimum of high school education; preferably with secretarial and computer background.
• General knowledge of spelling, punctuation, grammar, medical records and office procedures.
• Basic knowledge of office machines.
• Basic knowledge of telephone skills.
• Aptitude for computer data entry and use of current software systems.
• Ability to establish and maintain effective working relationships.
• Ability to meet the public and staff as a positive, friendly and professional representative of the agency.
• Effective social interaction, communication and organizational skills and the ability to perform a variety of tasks efficiently.
• Personal car for travel and valid driver's license.
• Any experience in hospice or clinical or healthcare is preferred but not required.

Job Type : Full-time

Pay : $80,000.00 - $110,000.00 per year

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