Essential Functions:  Clinical/Technical

• At the direction of the patient’s primary care physician, the Medical Director and the Director of Patient Care Services; coordinate quality palliative care to patients/families.
• Work collaboratively with referring community and Hospital institutions, Physicians, Medical Social Workers, Case managers, and GMCH Medical Directors to coordinate intake and screen for the appropriateness of admissions, transfers, and discharges.
• In coordination with IDT (interdisciplinary team) participate in developing, evaluating, and updating the plan of care for each patient/family.   Enter IDT notes into Allscripts.
• If requested by the nursing staff, communicate with the managing physician when reactions to treatments and medications and changes in the patient’s physical or emotional condition arise.
• Calculate medications and fluids with 100% accuracy.
• Work collaboratively with referring community and hospital institutions, Physicians, Medical Social Workers, and Case Managers to coordinate intake and screen for appropriateness of admissions, transfers, and discharges of patients.
• Review with primary Caregiver prior to respite admissions:  medications, feedings, treatments, procedures, and required paperwork.
• When needed: Prepare admission charts and enter the appropriate information required for preadmission in Allscripts.  Update resources and payor sources as needed.
• Set up with DME companies, in services as needed for incoming patients to ensure proper operation of DME and other equipment.
• Maintain current clinical knowledge of pediatric palliative care practices through ongoing education and attendance of in-service training sessions.
• Obtain authorizations for admissions from Private Insurance, Managed Medi-cal, Medi-cal, and Hospice Agencies.  Obtain POS from Regional Centers prior to respite stays.
•  Monitor patient stays and maintain timely communication with payor sources to justify the level of care for continuing stay review.
• Coordinate and oversee that the Billing Department receives an Encounter sheet with the appropriate payor source, copies of denials, authorizations, and demographics in a timely manner.  Assist the Billing Department with the resolution of any outstanding billing accounts/issues.  Attend Billing meetings as requested.
• Schedule Family/Patient interviews.  Oversee the designated LVN and review and ensure the completion of Plan of Treatment and TARS for Medi-cal Waiver billing per IHO requirements.
• Maintain a Daily Financial Report which details the patient, payer source, and rate.  Each Friday

Essential Functions:  Patient Interaction

• Actively participate in the provision of medical, psychosocial, and spiritual care for GMCH children-patients and their families when requested.
• Meet with patients and families for tours and preadmission paperwork as needed.  After admission meet with parents for any insurance-related issues/billing.
• Attend Medi-cal Waiver interviews when requested by parents.
• Communicate with patient/family regarding any billing or insurance issues and discharge for discharge planning needs.
• Refer Patient’s/Families to community resources to meet home care needs.

Essential Functions:  Team Communication

• Document all Communication in the Medical Record System (Allscripts).
• Attend scheduled Inter-Disciplinary Team (IDT) meetings and document discussion and any changes to a plan of care in Allscripts. Participate in Clinical meetings.
• Participate in the development of new GMCH policies and procedures.
• Maintain communication with patients, family, and hospital staff when a patient is transferred and/or hospitalized.
• Maintain patient confidence and protect GMCH operations by keeping all patient information confidential.

Other Essential Functions:  

• Perform tasks in a culturally sensitive manner without regard to any protected category as defined by federal, state, or local law.
• Utilize GMCH resources in a cost-effective manner.
• Maintain a clean and organized work area to reduce the likelihood of health and safety hazards.
• Effectively deal with personal psychosocial and bereavement issues related to job duties.
• Maintain professional boundaries within the Scope of Practice.
• Attend in-service training and staff meetings.
• Adhere to all state regulations regarding professional licenses.
• It is an essential function of this position to report to work on time for your scheduled hours, ready for work.
• Understand and adhere to GMCH compliance standards as they appear in the GMCH Personnel Manual, GMCH Policies and Procedures Manuals, and Departmental memos.