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UPMC

Clinical Referral Coordinator Nurse Home Care

Posted 5 hours ago
0-2 years experience
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AI Summary

Acts as a clinical liaison to coordinate complex patient referrals between physicians, hospitals, and insurance providers. Ensures accurate documentation and regulatory compliance while facilitating the admissions process for home health and hospice services.

UPMC Family Hospice is hiring a full-time Clinical Referral Coordinator for our team working Monday-Friday 8:30A-5:00P with weekend and holiday rotations. 


Coordinates qualifying referrals for the Home Health and Hospice service lines with the goal of achieving positive outcomes. Manages all clinically complex referrals. Problem solves solutions and education related to coordination efforts.

Responsibilities:

  • Acts as the clinical liaison that represents the Agency via telephone with referrals for patient care from physicians, hospitals, insurance case managers and all other referral sources. Promotes and maintains the continuum of patient care with referral sources.
  • Responds to phone calls, electronic transmissions, e-mails and faxes regarding clinically complex referrals with an extremely customer friendly, service orientation at all times.
  • Reviews physician orders and follows up with referral source for clarifications or additional information if needed. Ensures accurate Face-to-Face documentation and appropriate diagnoses are obtained in accord with regulatory requirements.
  • Accurately completes referral documentation as necessary to facilitate the admissions process.
  • Assist referral sources with clinical skill judgment to determine the patient care need(s). 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 policy and procedure.
  • Participates in the development of policies and procedures and actively assists in problem solving with and between departments to ensure the clinical intake function is collaborative and effective.
  • Focuses on customer service and continually strives to perform the duties of their job in a manner that will result in optimal patient satisfaction as well as internal and external relationships.


  • Completion of accredited school of professional nursing required. 
  • 1 year of experience in home health or hospice care strongly preferred. 
  • Clinical knowledge and critical thinking ability to effectively plan and provide coordination of patient care consistent with standards and regulations.

    Licensure, Certifications, and Clearances:
     
  • Registered Nurse (RN)
  • Act 34
  • OAPSA

*Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state.

UPMC is an Equal Opportunity Employer/Disability/Veteran

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