Northwell Health Registered Nurse (RN)- Home Care Referral Center in Westbury, New York

Req Number 001YPA

Job Category Home Care

Job Description

POSITIONSUMMARY

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.

RESPONSIBILITIES






  1. Reviews home care referrals from all sources.
  • Utilizes knowledge of homehealth services and regulations to ensure referrals have all necessaryclinical components.

  • Identifies services, disciplinesand appropriate clinical specialty program for referral.

  • Verifies active/currentphysician license information.

  • Facilitates insuranceauthorizations for home care service.

  • Reviews referral forcompleteness of clinical and demographic information.

  • Processes referral to initiateservices.

  1. Educates the community/referral sources on home care services.
  • Explains home care guidelinesfor Medicare, Medicaid, and all other payor sources.

  • Explains the types of home careproviders, i.e., CHHA, MLTCP, and licensed.

  • Assists in identifying type ofhome care service they need by asking pertinent questions about thepatient’s diagnosis and health care needs and available caregiverresources.

  1. Functions as an integral part of the Home Care Team by expanding theoretical knowledge base, improving clinical techniques, and enhancing interpersonal skills.
  • Demonstrates current andin-depth knowledge of clinical practice and available communityresources, differentiating varying levels of care needs.

  • Demonstrates the ability to makedecisions based on sound judgment.

  • Acts as a role model for HomeCare team members, students, patients and families.

  • Participates in PerformanceImprovement and Utilization Review activities within Home Care Network.

  • Contributes pertinentinformation via participation in staff meetings, conferences and otheractivities when appropriate.

  • Establishes and maintainseffective working relationships with patients, families and professionalassociates.

  • Demonstrates current knowledgeof professional and general health care issues.

  • Seeks information and knowledgeto enhance level of expertise.

  • Shares information learned withpeers.

  • Assists with providing orientation to new nursingpersonnel on policies,procedures and practices.

  1. Functions as an essential part of the Referral Center Team.
  • Facilitates theinformation/paper flow of referrals to ensure timely provision of homecare services.

  • Assists with insurance inquiriesand authorizations.

  1. Performs job functions in a fiscally responsible manner consistent with the Agency’s mission and vision.
  • Utilizes sound time managementskills in planning day-to-day activities and fulfilling job duties.

  • Demonstrates appropriate andefficient use of supplies and equipment.

  • Consistently meets theproductivity standard established by the Home Care Network.

  1. Performs related duties, as required.

*ADA Essential Functions

Qualifications

· Graduate of a two (2) or three (3) year approved nursing program. 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.