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Facility: GSS SD Sf Vlg
Location: Sioux Falls, SD
Address: 3901 S Marion Rd, Sioux Falls, SD 57106, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
This position has flexibility and is mainly Monday through Friday from 8:00 a.m.- 5:00 p.m.
Responsible for the development of internal and external referral relationships within the geographic territory, which may include face to face contact. Responsible for the screening of referrals and coordination of the admissions to the rehabilitation unit. In addition, this position will assist with coordination of external referral to admission conversion process and represent Sanford in community related activities. Early identification of candidates/potential clients, education of clients, family members, referral sources, and external payers regarding the effective and efficient utilization of program services and available resources, screening of clients through on site and/or telephonic assessment and record review in collaboration with physicians, nurses, therapists, social workers, case managers and other interdisciplinary team members involved in the client's care. Provides information necessary to facilitate referrals and subsequent admissions.
Performs activities and duties related to preadmission assessment screening and admission of clients to services along the rehabilitation continuum of care. Identify clients who meet program criteria and will benefit from program services and to facilitate effective care transitions to the rehabilitation setting for these clients. Coordination of a smooth transition from the referring facility or site to the rehabilitation setting. Family members or significant others may also be interviewed to obtain accurate information as to pre-morbid functional status, personal interests, cultural considerations, and discharge plans affecting the rehabilitation admission. Determination of medical stability, readiness for program participation, and ensuring that services recommended are appropriate, reasonable and necessary. Performs on-site and/or record review, including telephone preadmission screening and clinical assessment. Completes all required preadmission screening documentation to determine that services are appropriate, reasonable and necessary. Educates clients, family members or significant others, referral sources, interdisciplinary team members, external payers, and external case managers about rehabilitation program benefits and services and post-acute care services. Maintains a thorough knowledge of rehabilitation settings, post-acute care services, acuity trends and outcomes. Is essential in the continuum of care for individuals with disabilities or chronic illness. Promotes effective public relations with clients and families, healthcare providers, and the community.
Further responsible for accurately entering information into the system to categorize patients appropriately for reimbursement. Works closely with coders to ensure proper documentation in the medical record for each patient. Facilitation of benefit eligibility and precertification by payers prior to the rehabilitation admission. Recommending appropriate level of care and services for clients who are denied admission and providing guidance for clients who may benefit from rehabilitation admission in the future. Serves as the liaison case manager with the internal and external case managers to provide an appropriate and cost-effective plan for each client. Assists in facilitation benefit eligibility and precertification, including providing a plan of care and participating in external payer negotiations. Excellent assessment skills and knowledge of insurance and managed care principles and practices. Knowledge of regulations of agencies involved in program operation and resources available for use in assessing regulations and parameters of third-party reimbursement. Provides referral sources with cost-effective plans for rehabilitation.
Appropriate education level required in accordance with state licensure. Preferably from accredited school and/or program.
Minimum of three years’ experience in inpatient rehabilitation setting preferred. Working knowledge of rehabilitation regulations preferred. The ideal candidate will have marketing experience.
Currently holds an unencumbered license in one of the following: Registered Nurse (RN), Occupational (OT), Physical (PT), or Speech Therapist (ST) with the applicable State Board in state(s) of practice and/or possess multi-state licensure privileges as required by position.
Must maintain any additional specialty certification/licensure as required by profession. Some travel may be required based on region needs. When applicable, may require valid driver's license. Obtains and subsequently maintains required department specific competencies. Basic Life Support (BLS) certification required.
The Good Samaritan Society offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, sick leave and paid time off. To review your benefit eligibility, visit https://good-sam.jobs/benefits .
The Good Samaritan Society is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to firstname.lastname@example.org .
The Good Samaritan Society has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.
Job Function: Allied Health
Req Number: R-60777