Rehab Clinical Navigator and Admissions Coordinator

Job Summary and Responsibilities

As our Rehab Clinical Navigator & Admissions Coordinator you will serve as a vital clinical liaison between acute care providers and our inpatient rehabilitation facilities, ensuring a seamless referral process through expert education and strategic relationship building.

 

Every day you will perform clinical intake assessments and coordinate with insurance providers to facilitate efficient, safe, and CMS-compliant admissions into our rehabilitation units.

 

To be successful in this role, you will possess a strong clinical background and the ability to manage complex admissions workflows while maintaining professional partnerships with physicians and case managers.

• Manage clinical intake and eligibility: Assess patients’ needs, identify eligible rehabilitation candidates, and complete comprehensive prescreening of referrals. Prescreening involves rigorous evaluation of CMS criteria, medical acuity, stability, diagnosis, prognosis, medical necessity, functional impairments, and likelihood of benefit from an Inpatient Rehabilitation Unit (IRU)/Inpatient Rehabilitation Facility (IRF) environment.
• Admission facilitation: Promptly respond to referral requests, maintain effective communication with referral sources, and provide accurate patient assessment information to the assessment team. This includes traveling to other facilities as needed to complete the pre-screening of potential patients.
• Financial and approval processes: Verify patient benefits, obtain authorization for reimbursement prior to admission, and collaborate with the physical medicine team for final approval.
• Regulatory adherence and coordination: Initiate communication with the Director and Medical Director to ensure the uniform application of admission procedures and criteria, strictly adhering to all regulatory guidelines.
• IRF PAI completion and submission: Complete all sections of the IRF PAI in conjunction with the rehab management team and manage these submissions.
• Appeal process lead: Write up and navigate through the CMS appeals process regarding any appeals or ALJ needs as determined by CMS in conjunction with our internal appeals team.

Job Requirements

Required

• Bachelor’s Degree in Social Science or a related field
• Current license in the state of practice as a Registered Nurse (or a participating National Licensure Compact state), Physical Therapist, Occupational Therapist, or Speech-Language Pathologist (with Certificate of Clinical Competence from ASHA).
• Basic Life Support (BLS) certification from the American Heart Association.
• Five (5)+ years of experience in rehabilitation or another appropriate post-acute environment.

Preferred

• Bachelor’s Degree in Nursing (BSN)
• Master’s/Doctorate Degree in Physical Therapy; Master’s Degree in Occupational Therapy; or Master’s Degree in Speech Therapy.
• Certified Rehabilitation Registered Nurse (CRRN).
• One (1) year of proven marketing experience demonstrating a consistent ability to achieve objectives.
• Experience/knowledge in community health settings/services.

Where You’ll Work

Located in Lakewood, Colorado, St. Anthony Hospital is a Level I Trauma Center where we provide a full range of medical specialties and health care services to Denver and the surrounding region through our state-of-the-art medical campus and home base for Flight For Life® Colorado. With four trauma rooms including the T-10 room, a dedicated field-to-surgery suite ready 24/7 for trauma surgeons and specially trained teams, our staff can provide life-saving care to the most severely ill and injured patients. In 2023, we received our exciting Magnet® designation! We are so proud of our staff for this achievement, which is awarded to only 10 percent of hospitals around the world. Numerous other awards, certifications, and accreditations have been granted to us from the American Heart Association; Chest Pain Center (CPC); American College of Cardiology; The Joint Commission’s National Quality Approval; the Emergency Nurses Association Lantern Award; NAPBC Accreditation; American College of Radiology and many others. At St. Anthony Hospital. We combine a heritage of expert care with the latest in technology and innovation. If you’re looking to be part of a fast-paced environment where you can practice to the top of your profession in trauma, cardiology, stroke, neurosciences, breast imaging, cancer/oncology care, surgery and more, we invite you to apply.