The Elizabeth Seton Pediatric Center (Yonkers, New York) has an immediate full-time opportunity for a Continuity of Care Liaison to join our distinguished healthcare team.
We believe in the healing power of loving relationships. As a nationally-renowned pediatric specialty care facility, the Elizabeth Seton Pediatric Center is dedicated to providing the highest quality of care for the medically complex children we serve, from infancy through age 21. We strive to provide all of our residents with as many warm, nurturing and normalized childhood experiences as possible, and we recognize that providing a home-like environment gives our residents the chance to just be kids.
The Pediatric Center offers a uniquely rewarding experience for people with a passion for making a difference in the lives of children and families. Our staff is committed every day to ensuring that each child and their family feel safe, comfortable and cared for during their journey with us and even in the years after. These children, no matter how many months or years they're with us, become a part of our family.
Reporting to the Director of Admissions, the Continuity of Care Liaison will provide case management and discharge planning for medically fragile children, coordinating the teaching and offering of support to their families and coordination of medical/clinical services to ensure an optimal transition back to the community. In addition this position will assist in assessing children who would match the Pediatric center's admission criteria to maintain census at established budgetary standards.
Responsibilities include, but not limited to:
Understands ESPC Mission and Core Values and incorporates values into daily practice.
Continually strive to improve the organization's systems and/or services.
Make decisions as a team to fulfill our mission, share recognition, and learn from failures.
Treat every resident, family member, and co-worker with dignity, respect, and courtesy.
Provide discharge planning and coordination for short-term, managed care cases from Admission to Discharge.
In collaboration with the interdisciplinary team and family: identify a realistic time frame to meet discharge goals; Partner with the team to support discharge planning, reinforcing family education and family's ability to demonstrate competency, and identifying after care supplies and services; Identify specific equipment needs and medical services that will be needed in the community to affect a safe and appropriate discharge (DME, Nursing Services, follow-up care, etc.).
Liaise with the Insurance Plans/Managed Care Case Managers, providing clinical updates, obtaining authorizations and other information as needed for continued stay; work with interdisciplinary team to ensure treatment plan goals are being met and documented accordingly.
Coordinate start of care dates, delivery of equipment, training schedule, home assessment, etc. to ensure a safe and appropriate discharge process.
Conduct home visits when needed with selected members of the team to assess strengths and identify and barriers to discharge; work with the Family and Community Agencies to address barriers.
Collaborate with Social Work on addressing psychosocial barriers to discharge.
Complete and submit all paperwork, forms and letters of medical necessity to external systems as they relate to the discharge plan.
Provide after care support to residents and families with phone calls and home visits to bridge “institutional” to “community” services.
Liaise with outside equipment vendors and nursing agencies to ensure communication and documentation is timely to affect a safe and appropriate discharge.
Develop working knowledge of the admissions procedures to be able to maintain the admissions decision making process and transition of referrals through to admission in the absence of the Director.
Make onsite/in-hospital assessments of prospective admissions as part of the admissions decision making process and assist the Director of Admissions in identifying candidates from referral options who match the Center's criteria.
Liaise with external referral sources during the admission process (gathering clinical data, presenting cases to the Admissions Committee, providing information about ESPC and touring families through the facility).
Process each admission decisively with regard for confidentiality of all information related to: verification of Medicaid/Managed Care/ Private insurance, referral source documents, medical information; write an Admissions Summary; collaborate with Chief Nursing Officer and Director of Admissions in making a Neighborhood and room assignment.
Maintain confidential data base on referral source data and referral to admissions data; populate the Daily Grid of active referrals; and update the census and bed board.
Bachelor's Degree required
NY State Licensed RN
Care management or case management experience in a Health Plan, Hospital, Clinic or Nursing Agency. Discharge planning, or pediatric experience in an acute setting with medically complex children