Hospice Liaison: Hospice

• Evaluates patients referred to the Organization; identifies insurance coverage, negotiates payment or per diem rates; plans and coordinates referrals for home care services.
• Evaluates hospitalized patients referred for home care. Identifies and verifies insurance coverage of home health care services.
• Obtains and documents prior authorization for home care services from insurance providers.
• Negotiates per diem or per visit payment rates for creative bundling of home care services.
• Collaborates with the hospital's discharge planning personnel, utilization review department and insurance Case Managers to facilitate safe, early discharge.
• Consults with physicians, nurses, social workers, discharge planners and other disciplines to establish a coordinated home plan of care.
• Interviews the patient, family, and caregiver and discusses the home situation, current needs, and any psychosocial factors that are relevant to the plan of care.
• Completes referral information that includes intake data, essential background information, hospital course, and the plan of care.
• Maintains liaison relationship with hospital and insurance personnel, providing information and education on Organization services, coverage issues and related areas.
• Performs other duties as assigned.

Education and Experience

• High School diploma or equivalent.
• Minimum of 2-3 years' experience, at least 1 which is in the area of public health or home care nursing.
• Ability to work with other health care clinicians, development of home plan of care, knowledge of third party reimbursement, and ability to negotiate payment rates.

License Required:

Current LVN License to practice in the State of California

Certifications Required:

Current BLS Certification