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Manager referral center


At Lancaster General Health, our culture is what sets us apart and creates a lasting impression of our health system in the community and in the hearts of our patients and their families. A role with us is more than just a job, we ask that you Live Your Legacy at LGH by finding your passion in your everyday role, committing to those you serve, and reaching for your personal best.

We are recognized as 1 of only 9 hospitals in the entire country with awards in Medicare.Gov, LEAPFROG and Healthgrades Americas 50 Best Hospitals. We have attained five year Magnet ® recognition status for the fifth time with the American Nurses’ Credentialing Center (ANCC) and we are the 2018 recipient of the Foster G. McGaw Prize in recognition of the commitment to community service.

PENN MEDICINE LANCASTER GENERAL HEALTH offers a comprehensive benefits package:

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program so that our employees can stay actively engaged and committed to living their legacy every day. Together, we will continue to make medical advances that help people live longer, healthier lives.

Join us and be part of a team that empowers you to do more than your job and encourages you to:

Live Your Passion. Live Your Best. Live Your Commitment. Live Your Legacy.

Company

Penn Medicine Home Health

Cost Center

2015 Administration/Shared Services

Supervisory Organization

Referral Center

Grade

G16

Benefits of Joining Penn Medicine Lancaster General Health:

PENN MEDICINE LANCASTER GENERAL HEALTH combines a Nationally Ranked Hospital with great schools, safe neighborhoods, affordable housing, local community events and festivals as well as a wealth of cultural and recreational activities. The scenic Susquehanna River Valley provides opportunities for fishing, skiing, kayaking, hiking and mountain biking in addition to easy access to NJ shoreline or Delaware beaches. Urban life is easily accessible, with New York, Baltimore, Philadelphia and Washington D.C. a train ride away. Local universities, Fulton Theatre, the downtown shopping and dining district and local sports teams make Lancaster a great place to Live, Work and Play.

Summary

POSITION SUMMARY: Supervises and manages the day to day operations of the Referral and Pre-Auth Departments.

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

  • Directs daily operations of assigned department(s) including staffing at optimum levels to maximize productivity.  Accountable to manage expenses and salaries through control of overtime and staff productivity.  Anticipates potential problems and intervenes proactively.  Plans and implements problem-solving strategies when budget targets are not met.
  • Selects, retains, and develops qualified staff.  Evaluates staff performance and competence in completion of assigned duties. Counsels and coaches staff and takes appropriate disciplinary action as needed.  Ensures excellent custom service practices by all members of assigned departments.
  • Supervises and coordinates the referral and admission process including:
    • Acceptance and processing of accurate referral information
    • Verification of benefits and authorization of initial services
    • Admission activities with team schedulers, patient care liaisons and Clinical Managers/Directors
    • Communication of patient insurance/reimbursement benefits by third party payers to Pre-authorization staff and Billing Office staff
  • Supervises the coordination of acceptance of referred patients and approves any non-acceptance of any referred patient.
  • Monitors and reports referral statistics and other data required by agency and/or hospital partners.
  • Identifies trends in referral patterns and participates in activities to adjust to changes.
  • Interacts routinely with referral sources (i.e. hospital case managers, discharge planners, physicians, etc.) to maintain relationships, address service failures and complaints.
  • Ensures authorizations are obtained when needed for all services.
  • Analyzes the work flow related to effectiveness and efficiency in the work environment and fosters an environment of continued quality and performance improvement.
  • Participates in the development of policies and procedures and actively assists in problem solving with and between departments to ensure the intake function is collaborative and effective.
  • Maintains current knowledge of industry regulations as they relate to assigned responsibilities.       

SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:

  • Works with Directors and Clinical Managers to improve the intake to admission process.
  • Works with Directors and Clinical Managers to improve the Pre-authorization process.
  • Consults with the agency directors to stay current and clarify regulatory requirements for accepting patients into home health.
  • Participates in interdepartmental meetings, task forces, and committees, as assigned or requested including developing, implementing and evaluating clinical and agency policies and procedures.
  • Other duties as assigned.

JOB REQUIREMENTS

MINIMUM REQUIRED QUALIFICATIONS:

  • Knowledge of current home health admission criteria including Medicare, Medicaid, State, and Federal regulations is preferred.
  • Previous management experience.
  • Previous health care experience.
  • A health care provider in good standing with Medicare, Medicaid, and other federal and state health insurance programs, i.e. not excluded from participation in Medicare, Medicaid or any other federal or state health insurance program.

PREFERRED QUALIFICATIONS:

Bachelor’s degree preferred. Registered Nurse in the state of Pennsylvania is preferred.

COGNITIVE REQUIREMENTS

Attention/Concentration: The following level of ability is essential for the jobholder to focus on certain aspects of current experience and reject others:

  • The position requires the ability to attend to more than one aspect of a situation simultaneously.  It is highly likely that multiple task demands are going to be required of the individual at the same time.

New Learning and Memory: The following level of ability is essential for the jobholder to learn and retain material:

  • A large portion of this position required reliance on verbal memory and new learning.  Efficiency in processing of verbal information, either in written or spoken form, is a major requirement and prerequisite of the job.  The individual must be able to attend to and process multiple bits of information simultaneously.  The individual must be able to organize and categorize this information effectively so that later recall is feasible.

Problem Solving, Reasoning and Creative Thinking: The following level of ability that is essential for the jobholder to think (in order to solve a problem) by combining two or more elements from past experience or imaginative thought:

  • The position required much autonomy of thought and problem solving.  The individual must be able to apply principles of logical or scientific thinking to define problems.  The individual must be able to think abstractly, which is manifested in the ability to form concepts, use categories, generalize from single instances, apply procedural rules and general principles, and be aware of subtle or intrinsic aspects of a problem.  The development of hypothesis and potential solutions to problems involves careful interpretation, analysis and diagnosis.  The individual must be able to collect data, establish facts, and draw valid conclusions.  The individual must be able to think creatively with a degree of inventiveness, experimentation and intuition.  They must be able to deal with a variety of concrete and abstract variables.

TEMPERAMENTS:  The following are essential requirements of the position in relation to job-worker situations.  These items describe how a worker must adapt, adjust, conform or act:

Leadership, control and planning: Ability to accept responsibility for leadership, direction, control, planning, negotiating, organizing, directing, supervising, formulating practices, or making final decisions.

Creativity, feelings or ideas: Ability to adapt to situations involving the interpretation of feelings, ideas, or facts in terms of personal viewpoint; to use creativity, self-expression, or imagination.

Influencing others: Ability to influence people in their opinions, attitudes or judgments about ideas or things; to motivate, convince or negotiate.

Working within tolerances, set limits or standards: Ability to adapt to situations requiring the precise attainment of set limits, tolerances, or standards; to be precise, thorough, exacting, or meticulous in regard to material worked; or in activities such as numerical determinations, record preparation, or inspecting.

Performing under stressful conditions: Ability to perform under stress when confronted with emergency, critical, unusual, or dangerous situations, or in situations in which working speed and sustained attention are critical aspects of the job. Is subject to danger or risk, or to tension as a regular, consistent part of the job.

Variety and change: Ability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure involving significant differences in technologies, techniques, procedures, environmental factors, physical demands, or work situations.

Communication:  Ability to exchange information with others clearly and concisely; to present ideas, facts and technical information.

Planning and control: Ability to identify task requirements and monitor progress toward accomplishment.

Interpersonal relations: Ability to maintain relationships that facilitate task accomplishment; to cooperate and resolve conflicts; to recognize needs and be sensitive of others.

Language: Reading, Writing & Speaking:

  • Ability to read a variety of books, magazines, instructions, and encyclopedias.
  • Ability to prepare business letters, proposals, summaries, and reports; using prescribed format and conforming to all rules of punctuation, grammar, diction, and style; using all parts of speech.
  • Ability to communicate distinctly with appropriate pauses and emphasis; correct pronunciation (or sign equivalent) and variation in word order; using present, perfect, and future tenses.

Mathematics: The following levels of ability are necessary to understand mathematical concepts and apply them to problem-solving situations.

  • Ability to add, subtract, multiply, and divide all units of measure.
  • Ability to perform the four operations with like or common decimal fractions.
  • Ability to compute rate, ratio and percent.

EQUIPMENT USAGE REQUIREMENTS: MACHINES, EQUIPMENT, TOOLS, SOFTWARE: To perform the essential duties of the position, use of the following machines, equipment, tools, and software is customarily required:

Machinery/Equipment: Computer, phone, copier, printer, fax

Tools:   office supplies

Software:   Microsoft Office Products

PHYSICAL REQUIREMENTS: Degree of physical exertion is light, exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to move objects.

BODY POSITION AND MOVEMENT: The following positions or movements are typical of the job:

  • SITTING is done frequently.
  • WALKING is done occasionally.
  • STANDING is done occasionally.
  • CLIMBING is done seldom.
  • REACHING (Extending out and retrieving objects outside immediate range) is done seldom.
  • PUSHING (To press against something with substantial steady force in order to thrust forward, downward or outward) is done occasionally.
  • PULLING (To exert a considerable force in order to draw, drag, haul or tug objects in a sustained motion) is done seldom.
  • LIFTING (To raise objects from a lower to a higher position or moving objects horizontally from position to position) is done occasionally.
  • END‑RANGE MOTION (To fully extend or retract a bodily part or joint to its maximum range in order to reach, push, pull, lift, or otherwise perform job functions) is done seldom.
  • STOOPING/CRAWLING (To lower the body to floor level, and move about with agility) is done seldom.

VISUAL REQUIREMENTS:  (Considerations include color, depth perception and field of vision).

  • The job requires a good sense of vision (with or without correction) necessary to distinguish like objects from one another, to scan fields of data and select numbers or characters, and/or to detect and visually follow moving objects.

AUDITORY (HEARING) REQUIREMENTS: Examples of the types of sounds that must be heard and the reason they must be heard are listed below:

SOUND                                 PURPOSE

voices                                     to converse, communicate

telephone ringing                 to answer incoming calls

WORKING CONDITIONS: Exposure to hazardous conditions/ materials is negligible.

Disclaimer: This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job.  It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards.  The percentages of time spent performing job duties are estimates, and should not be considered absolute.  The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole.  Incumbent must be able to perform all job functions safely.

Disclaimer

PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.

 

Search Firm Representatives please read carefully: PENN MEDICINE LANCASTER GENERAL HEALTH is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, all resumes submitted by search firms to any employee at PENN MEDICINE LANCASTER GENERAL HEALTH via-email, the Internet or directly to hiring managers at Penn Medicine Lancaster General Health in any form without a valid written search agreement in place for that position will be deemed the sole property of PENN MEDICINE LANCASTER GENERAL HEALTH, and no fee will be paid in the event the candidate is hired by PENN MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means.

VNA-LANC Full Time Posted on 06/21/2021