Welcome to Lahey Health Continuing Care, part of Beth Israel Lahey Health. Our team provides ongoing care to individuals through our assisted living and skilled nursing facilities. Our teams of nurses, aides, food service, and environmental service employees work to create an environment that supports the physical, mental, emotional, and spiritual needs of our residents and patients, along with their families.
About the Job
Position Summary: Reporting to the Executive Director of Hospice and Palliative Care, the Clinical Liaison is responsible for developing and maintaining relationships with referral sources and generating referrals to BILH at Home programs. The Clinical Liaison meets directly with patients, families, their caretakers, and/or case managers and performs a clinical assessment to determine appropriateness of referral.
Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve. Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health.
Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.
Essential Duties & Responsibilities, including but not limited to:
- Identifies and follows through with new patient referrals for home health and hospice services as appropriate.
- Identifies and follows through with new patient referrals to skilled nursing facilities when appropriate.
- Reviews and evaluates patient’s medical record utilizing sound clinical judgment, knowledge of skill requirements, and reimbursement systems to ensure appropriateness and desirability of referral.
- When appropriate, meets with patients, family members and care takers to provide information about skilled nursing and/or home health and hospice services.
- Coordinates patient discharge plans with hospital case managers and hospitalists to ensure patient receives appropriate level of care and service.
- Communicates patient referral information to the appropriate admission or intake department ensuring accurate and complete information to facilitate continuity of care with a smooth transition from one care setting to another.
- As part of the clinical liaison service team, the Clinical Liaison works on-site at internal facilities providing liaison services. The Clinical Liaison adheres to the policies, procedures, and work schedule according to the facility (ies) they are assigned.
- Completes all clinical and administrative documentation in an effective and efficient manner using the current electronic medical record and e discharge system in keeping with established policies and procedures.
- Maintains confidentiality and compliance related to patient rights, HIPPA (Health Insurance Portability and Privacy Act), and other regulations and protocols related to dealing with health information privacy.
- Cultivates referral relationships with physicians, case managers, social workers, and other potential referrers.
- May assist with representing LHH and delivering professional educational programs to increase understanding of home health and hospice services with the goal of developing new referral sources.
- May attend meetings and clinical rounds at assigned referral sites.
- May represent LHH at community events, networking groups, professional membership organizations, health fairs and expositions, and other related activities.
- Travels locally, on a regular basis, to other LHS program sites, referral source sites, contracted facilities, community agencies and meetings.
- May participate in weekend and holiday rotation schedules as needed.
- Maintain strict adherence to the BILH at Home Confidentiality policy.
- Incorporate BILH at Home Standards of Behavior and Guiding Principles into daily activities.
- Comply with all BILH at Home Policies.
- Comply with behavioral expectations of the BILH at Home Division.
- Maintain courteous and effective interactions with colleagues and patients.
- Demonstrate an understanding of the job description, performance expectations, and competency assessment.
- Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
- Participate in departmental and/or interdepartmental quality improvement activities.
- Participate in and successfully completes Mandatory Education.
- Perform all other duties as needed or directed to meet the needs of the department.
- Registered Nurse from a Graduate of National League for Nursing accredited school of nursing.
- BSN, strongly preferred.
Licensure, Certification & Registration
- Registered nurse with current licensure to practice professional nursing in the state of Massachusetts.
- Has an active American Health Association BLS. If no American Heart Association BLS the employee must complete an annual BILHAH BLS Competency. No other forms of BLS will be accepted.
- Two to five years of direct care experience in an acute care, home care, or senior care setting.
Skills, Knowledge & Abilities
- Demonstrated clinical assessment skills with plan of care coordination experience, discharge planning, case management and patient advocacy preferred.
- Proficiency with site-based and remote access electronic health and medical records.
- Self-starter with solid organizational skills who can exercise independent judgment.
- Demonstrated ability to build and foster relationships, and work effectively with healthcare professionals both internal and external to LHSC.
- Highly-developed customer service, interpersonal, verbal, and written communication skills.