About Texas Children's HospitalSince 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years. Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation. To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.
We are looking for a Rehab Care Coordinator to serve as an integral member of the interdisciplinary Inpatient Rehabilitation Team through proactive planning, organizing, coordinating, monitoring, and evaluating services provided to patients admitted to the IRU. Responsible for ensuring consistency and quality of the referral/admission process, direct patient/family pre-admission assessment, coordination of patient admission to the IRU, team collaboration to ensure a safe discharge, referral source marketing and community liaison.
Think you have what it takes?
This person will be responsible for ensuring payer funding through verification and securing of admission pre-authorizations, continual case
management of patient goals and outcomes within effective and appropriate time frames, and ensuring that payer/regulatory
conditions are met.
• Maintains professional relationship with payer representatives and assists in resolving any utilization issues that arise.
• Promotes a smooth transfer of information between payer representatives, community providers and healthcare team.
• Pro-actively communicates with the Inpatient Rehabilitation interdisciplinary team.
• Ensures communication to the family and Inpatient Rehab interdisciplinary team via patient/family conferences and complete documentation.
• Collaborates with Inpatient Rehabilitation interdisciplinary team and payer representatives to advocate for Post-Acute Inpatient Rehab discharge equipment and services.
• Provides ongoing education to members of the Inpatient Rehab interdisciplinary team regarding pertinent aspects of Care Management including but not limited to utilization management, care Coordination, transition/discharge planning, and psycho-social patient needs.
• Verifies benefit status, coordinates pre-authorizations and enters data into appropriate hospital system.
• Assures timely performance of utilization management processes to maintain compliance with Federal, State, and Managed Care contract regulations.
• Ensures required justification and documentation is provided to payers.
• Assures timely progression occurs to appropriate levels of care.
• Utilizes evidence-based tools to analyze and identify trends/patterns of performance through variance reporting to improve quality and satisfaction and to decrease variation and cost.
• Develops an understanding of responsibilities for participation in QI/Performance Improvement activities.
• Assists in the development and implementation of best practices to optimize resource management to achieve desired outcomes.
• Participates in an analysis of a representative sample of records of the persons served.
• BSN or A.DN that is BSN enrolled
• 1 yr. RN experience
• Knowledge of specific nursing processes, anatomy and physiology as well as knowledge and familiarity with rehabilitation and CARF (Commission on Accreditation of Rehabilitation Facilities) accreditation standards.
• Excellent verbal and written communication skills, analytical decision making and judgment skills, demonstrated ability to function as a clinical care team leader, knowledgeable of all clinical resources available to patients both inpatient and outpatient, and data entry /word processing skills.
• CRRN – Cert Rehabilitation RN
• Experience in Case Management/ Coordination, Quality Management, Utilization Review, or discharge planning
• Experience in Pediatrics
• Bilingual (Spanish)