Physician Navigator PRN | San Antonio NE Rehab

Overview

This position is responsible for the relationship management aspects of referral development in a specific market. This
includes physician office calls networking and participation in professional healthcare organizations and support of
community initiatives such as health fairs/screenings Run/Walks or other community sponsored activities that provide
opportunities to raise general awareness of PAM Health programs and services. Performs other related duties as
assigned or requested. This is a non-exempt position that reports directly to the Director of Strategic Initiatives and
Integration.

Responsibilities

I. Direct Marketing
Identifies and targets new referral sources for PAM Health within assigned territory.
Establishes and maintain strong relationships with referral sources in assigned territory through ongoing
assessment and servicing of their rehabilitation needs.
Performs in-person appointments to market PAM Health programs to designated referral sources within assigned
territory and meet assigned objectives on a weekly basis. Communicates clearly concisely and accurately.
Maintains an excellent understanding of all inpatient/outpatient programs including features and benefits of such
programs throughout the system.
Meets assigned objectives for weekly calls joint marketing professional tours and educational presentations.
II. Pre-Admission Assessment
Maintains responsibility for patient referral until patient admits to PAM Health.
Displays knowledge of both inpatient rehabilitation and long-term acute care (LTACH) admissions criteria for preassessment analysis.
Coordinates and completes on-site pre-admission assessments on potential patients unless geographically
prohibitive or competitive time of admission will not the assigned market uses the fast track process to
facilitate referral conversions. Completes phone/FAX assessments if geographically prohibitive. Documents preadmission assessments legibly accurately and completely in the approved format.
Reviews medical record of referred patient and identifies all aspects related to pre-certification financial coverage
and admission criteria. Serves as a navigator to the Admissions office for insurance companies and provides
clinical information to obtain pre-certification from payers.

After reviewing medical record and interviewing patient/family obtains facility admission information to support
the admission process; makes a recommendation regarding acceptance and level of care and communicates
status of admission to referral source as directed by the admissions department.
Orients patient and/or family to facility services including length of stay. Educates supports and serves as a
resource to family members of current past and potential patients.
Communicates with facility Admissions department and facility CEO on a daily basis to optimize census
management and case finding strategies.
Follows up on all pending as well as medical denials in person to re-evaluate potential for admission.
Conducts follow up with referral facilities to ensure satisfaction and service levels were met.

III. Documentation and Reporting
Completes and submits weekly call reports in a timely manner. Submits time and expense reports and American
Express receipts by second working day each month.
Maintains a current and complete record of all contacts within assigned territory utilizing the sales database
(Upshot).
Maintains customer profiles (Physician Case Manager Employer etc.) in Upshot and updates as needed.
Contributes to ongoing market research by gathering information on the market and forwarding to management.
Provides management with identified areas of need or activities that will enhance the marketing endeavors of the
organization.
Assists in the development of new programs and enhanced services through ongoing assessment of stakeholder
needs of the market.
Identifies new business/partnership opportunities and communicates to management.
IV. Managed Care Relationships
Identifies opportunities for contracting with managed care companies and provider networks.
Coordinates appointments with managed care companies and PAM Health Case Managers and/or Director of
Managed Care as appropriate
V. Customer Service
Maintains the highest level of customer service via courtesy compassion and positive communication.
Promotes the mission and vision of PAM Health within the work environment and the community.
Respects dignity and confidentiality by adherence to all applicable policies and procedures.
VI. Health and Safety
Works in a manner that promotes safety; wears clothing appropriate to the performance of the job.
Participates in OSHA required training.
Follows universal precautions as appropriate for position; complies with Employee Health requirements for
continued employment.
Reports unsafe practices to management.
Knows own role in case of an emergency.

Qualifications

Education and Training: License in nursing therapy or social work or significant healthcare experience in marketing.
Computer literate and desire to enhance skills with PAM Healths information system software.
Experience: Must have a minimum of two years of experience in healthcare sales/marketing. Prior experience calling on
physicians is desired.
Knowledge Skills and Abilities:
Excellent clinical and assessment skills.
Effective presentation and training skills.
Excellent written and oral communication skills.
Effective crisis management skills with demonstrated facilitation and problem solving experience.
Effective team leadership skills.
Knowledge of PPS payment/reimbursement systems and DRGs/case weights.
Knowledge of patient rights and commitment to patient advocacy.
Ability to collect document and analyze data.
Word processing and data entry skills.
Network access to community state and national resources and health services organizations.
Excellent relationship management skills with referral sources and physicians.