(LPN) Clinical Referral Reviewer - ProHealth Home Health and Hospice (Birmingham, AL)

A Licensed Practical Nurse who assists the Branch Management staff with reviewing and approving referrals sent from Intake to the Branches for acceptance. The Clinical Referral Review specialist will review all referrals with branch limitations and coordinate with the Branch Management Staff. The Clinical Referral Reviewer is available at all times during operating hours (or appoints a similarly qualified alternate) and participates in all activities relevant to professional services furnished.

1. Graduate of an approved school of professional nursing and currently licensed in the state of which practicing; MSL required.

2. Three to five (3-5) years of experience in Home Health, preferred.

3. Knowledge of day-to-day Home Health operations preferred.

4. Ability to exercise initiative and independent judgment.

5. Ability to maintain organization and exhibit good time management habits.

6. Acceptance of philosophy and goals of the Home Health Company.

7. Ability to work with individuals to enlist cooperation of many people to perform/achieve a common goal.

Responsibilities

1. Understands and adheres to established company policy and procedures.

2. Works closely with the Central Intake Department, Intake Manager, and/or Director of Intake.

3. Coordinates and/or consults with Branch Management staff (Branch Director, Clinical Managers/Clinical Manager Assistants, Schedulers).

4. Understanding of Branch limitations for referral acceptance (staffing, coverage area, patient acuity).

5. Daily coordination with Branch Management staff to stay up to date on branch level referral acceptance limitations.

6. Thorough review of all referrals sent from Central Intake to ensure best outcome for the patient and the branch(es).

7. Understanding of home health practices and terminology.

8. Participates in studies and research or other administrative functions as assigned.

9. Serves as a role model for other colleagues by setting an example of high standards in dress, conduct, cooperation, and job performance.

10. Observes confidentiality and safeguards all patient related information.

11. Accepts responsibility for regular attendance and punctuality; fulfills job-related requirements without regard to time involved.

12. Serves as a resource for Branch Management staff employees.

13. Develops a cooperative relationship and communicates effectively with all employees.

14. Reports problems or concerns to Supervisor.

15. Must be able to perform nursing functions in times of staff shortage.

16. Other duties as assigned by the Regional Director of Operations.

Works indoors/office space.

1. Supervised by: Director of Intake

Low Risk

Ability to perform the following tasks if necessary

• Ability to participate in physical activity.
• Ability to work for extended periods of time while sitting, standing and/or being involved in physical activity.
• Moderate lifting.
• Ability to do moderate bending, lifting, and standing on a regular basis.

I have read the above job description and fully understand the conditions set forth therein, and if employed as a Verification and Authorization Specialist, I will perform these duties to the best of my knowledge and ability.