The posted compensation range of $23.31 - $32.04/Hour is a reasonable estimate that extends from the lowest to the highest pay Pathways Home Health & Hospice in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. Pathways Home Health & Hospice may ultimately pay more or less than the posted range as permitted by law.

POSITION SUMMARY:

Process Home Health and/or Hospice referrals for those patients needing Home Health/Hospice. These patients must meet the established criteria for Home Health or Hospice. They communicate Pathways Home Health and Hospice patient criteria and agency policies to community and provide resource for information regarding our services. 

AREAS OF RESPONSIBILITY:

• Collaborates with nurse managers, directors, Team Support coordinators, Case Managers, physicians, discharge planners, and other referral sources for eligibility and appropriateness of home care or hospice services. 
• Responds to all incoming referrals from eFax, Allscripts, Curaspan, Epic and any other referral sources and enters information into the system.
•  Manages tracks and processes patient referral paperwork and documents in the EMR system and other systems as appropriate. 

• Evaluates referrals for appropriateness to agency services or other community resources.
• Receives and documents verbal and/or written physician orders. 

• Verifies, enters, and updates facility database with physician’s information. MD license, DEA, PECOS, NPI number, and address as required. 

• Initiates the insurance verification process for Medicare eligibility for HH patients by using the DDE system. Follows up if DDE indicates a primary other than Medicare. 

• Verifies insurance coverage, identifies diagnosis, requests Authorization for new referral.  

• Represents agency services to the community. 

• Updates and maintains the Department logs eg: Projection log tabs.
• Participates in quality improvement activities. 

• Assists in maintaining and developing policy and procedures relating to the Care Management Team. 

• Provides back up to the Care Management Team staff. 

• Performs other duties as assigned consistent with skills and training and the goals and mission of the agency.

QUALIFICATIONS:

• Experience in Home Health and Hospice clinical setting preferred

• Knowledge of managed care approach to health care delivery. 

• Good telephone interviewing assessment skills. 

• Must be knowledgeable in agency services, requirements and governing regulations. 

• Knowledge of community resources and requirements. 

• Strong organizational skills with ability to work independently. 

• Must have the ability to cross train into neighboring functions. 

• Possesses strong customer services approach. 

• Must have the ability to perform in a team environment. 

• Current California drivers’ license and automobile insurance.