Description

• Act as liaison between manage care organizations and the facility's professional clinical staff.

• Conduct reviews in accordance with certification requirements of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.

• Inform clinical and medical staff of any specific concerns that would extend or restrict the length of stay of patients.

• Keep accurate record of all contact with external organizations and persons who have legitimate interest and legal access to information on the care of patients.

• Act in coordination with the leadership team of the facility or Corporate office to improve the quality of services provided within the organization.

• Perform other functions and tasks as assigned.

Qualifications

Skills

Preferred

• Customer Focus: Novice

• Communication: Novice

Behaviors

Preferred

• Thought Provoking: Capable of making others think deeply on a subject

• Team Player: Works well as a member of a group

• Innovative: Consistently introduces new ideas and demonstrates original thinking

• Enthusiastic: Shows intense and eager enjoyment and interest

• Dedicated: Devoted to a task or purpose with loyalty or integrity

Motivations

Preferred

• Flexibility: Inspired to perform well when granted the ability to set your own schedule and goals

• Self-Starter: Inspired to perform without outside help

• Growth Opportunities: Inspired to perform well by the chance to take on more responsibility

• Financial: Inspired to perform well by monetary reimbursement

• Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization

Education

Preferred

• Masters or better in Social Work

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)