Clinical Referral Specialist - Healthcare

Purpose of Position

The Clinical Referral Specialist is responsible for clinical liaison activities within the Referral Management Department. The Clinical Referral Specialist manages all clinically complex home health referrals.

• Represents the agency via telephone with referrals for patient care from physicians, hospitals, insurance case managers and all other referral sources
• Responds to phone calls, electronic transmissions, e-mails and faxes regarding clinically complex referrals with a customer friendly service orientation
• Accurately completes referral documentation as necessary to facilitate the admissions process
• Follows up with referral source for clarifications or additional information if needed
• Identifies objections, concerns or other entry barriers and provides information in response to address those issues. Proactively offers alternatives if the agency is unable to provide services.
• Processes and documents referrals that are not accepted for admission, indicating specific reason for non-acceptance according to agency policy
• Participates in the development of policies and procedures for referral management and actively assists in problem solving with and between departments to ensure the intake function is collaborative and effective.
• Maintains positive professional relations with support personnel through appropriate and timely response for information or paperwork necessary for key clinical and billing functions
• Displays a positive and professional image and attitude in all relationships with patients, families, peers and in the community
• Participates in the Quality Assessment Performance Improvement (QAPI) program
• Demonstrates flexibility in meeting the needs of the department and responds positively to changes in workflow
• Promotes teamwork by demonstrating willingness to assist others in meeting the needs of all individuals and collaborating effectively with the interdisciplinary team and other departments throughout the organization
• Complies with agency infection prevention and control and safety policies
• Completes annual competency requirements
• Consistently communicates requests, suggestions, concerns or problems to the appropriate personnel
• Consistently completes assigned responsibilities in required time frame and accepts additional duties and responsibilities as requested by Director of Referral Management
• Consistently maintains a professional appearance
• Protects patient health information according to the HIPPA rule and related Aultman policies
• Creates and fosters a work environment that is consistent with the Mission, Vision and Values of the Aultman Health Foundation
• Supports strategic organizational goals
• Abides by the Aultman Code of Conduct at all times

The above statements reflect the general duties considered necessary to describe the principle functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent to this position.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, disability, or veteran status.

• Must be a registered nurse with a minimum of six months’ recent clinical experience, minimum of one year of recent clinical experience preferred
• Experience in coordinating/processing home health referrals and/or at least one year’s experience in a home health, hospice, or community heath setting strongly preferred
• Clinical knowledge and critical thinking ability to effectively plan and provide coordination of patient care consistent with standards and regulations
• Exceptional interpersonal and customer service skills; must be able to effectively solve unique problems as they arise or identify when to consult the supervisor.
• Knowledge of current home health admission criteria and Medicare, Medicaid, State and Federal regulations
• Demonstrated problem-solving abilities and excellent telephone, interpersonal and written communication skills.
• Strong commitment to teamwork and customer service, both internally and externally, is required
• Strong/proven data entry and general computer skills

• Hours of operation with shifts as assigned including occasional overtime, on-call or off-shifts (evenings and/or weekends) scheduled as necessary.
• Subject to frequent interruptions and changes in priority of duties throughout the day.
• May be subject to emergency and other crisis situations
• Hazardous Exposure Category 3
• Sitting/standing/moving about during working hours (see attached Physical Requirements Addendum for details)

Purpose:

To identify specific functions job requirements and work environment factors that could affect job performance.

Check all factors that are present as essential job requirements and check whether the factor is performed.

O = Occasionally = 0- 33% of the work shift or 0- 32 repetitions.

F = Frequently = 34-66% of the work shift or 32-200+ repetitions.

C =…