Resource Clinical Navigator | PAM Health Corporate

Overview

This position works under the direction of the Business Development Educator and serves as a national clinical and business development resource supporting PAM Health hospitals and markets. Cultivates referral relationships, supports census growth initiatives, completes patient assessments, and assists facilities with operational and business development support. Extensive national travel is required.

 

This position is a role that will require extensive travel nationally across our entire markets throughout the US. 

Responsibilities

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 pre-assessment analysis.

· Coordinates and completes on-site pre-admission assessments on potential patients unless geographically prohibitive or operationally impractical. Completes phone/FAX assessments if geographically prohibitive. Documents pre-admission 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.

· Obtains and reviews admission information by evaluating the patient's medical record and interviewing the patient and/or family to support the admission process. Assesses the patient's appropriateness for admission, recommends the appropriate level of care, and communicates the admission status to the referral source in coordination with 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.

· Provides temporary market support during hospital openings, staffing transitions, census growth initiatives, and operational needs.

 

Business Development

· Supports and assists with marketing strategies for assigned facilities and markets nationwide.

· Uses sales and marketing techniques to support growth in admissions and revenue volume.

· Collaborates with Business Development Educators and local leadership to support market action plans and growth strategies.

· Utilizes educational opportunities to present PAM Health hospitals and services to referral sources.

· Identifies contacts and manages potential referral sources using approved account management systems.

· Uses prospecting methods to generate leads and referral opportunities.

· Supports referral and admission goals for assigned facilities and territories.

· Participates in community events and activities.

· Attends required Business Development meetings and operational calls.

· Functions as a national resource supporting facilities across multiple markets as assigned.

 

Market Education

· Identifies and educates new referral sources to PAM Health programs and services.

· Assesses and conveys stakeholder needs. Establishes and maintains strong relationships with providers through ongoing assessment and servicing of their rehabilitation/LTACH needs.

· Schedules educational in-services to educate referral sources about PAM Health programs and services; works closely with Admissions departments, Business Development Educators, DSIs, CEOs, and local leadership teams to achieve census goals and assigned objectives.

· Provides or arranges educational presentations to referral sources, physicians, discharge planners, families, and community members as requested.

· Coordinates and schedules professional, family, and/or potential patient tours of facilities.

· Gathers information on healthcare providers in facility service areas and forwards opportunities and market intelligence to leadership.

· Assists in the development of new programs and services through ongoing assessment of professional, family, and patient needs.

· Remains current on new programs and services in the PAM Health System through frequent communication and facility visits.

· Assists with onboarding, mentoring, and field training support for business development and admissions team members as assigned.

Documentation Reporting

· Effectively maintains log of all pending cases.

· Provides periodic verbal, telephone, and email updates on activities, operational barriers, and market trends as requested.

· Maintains a resource library of articles and information for distribution to professionals, community members, families, and potential patients to assist them in understanding facility services and disability groups served.

· Completes required reports, updates, and territory planning documentation.

· Maintains territory Account Management System and related reporting tools.

Customer Service

· Maintains the highest level of customer service via courtesy, compassion, responsiveness, and positive communication.

· Promotes the mission and vision of PAM Health within the work environment and community.

· Respects dignity and confidentiality by adherence to all applicable policies and procedures.

· Demonstrates professionalism and adaptability while supporting varying markets, leadership teams, and operational environments.

 

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:

Degree in a health-related field from an accredited college or university preferred. Current licensure in nursing, respiratory therapy, physical therapy, occupational therapy, or speech and language therapy is required. Prior marketing and/or rehabilitation/LTACH experience preferred.

 

Experience:

Must have a minimum of two years’ experience in the designated field of license, preferably with rehabilitation/LTACH and marketing experience. Experience supporting multiple facilities or markets preferred.

Knowledge, Skills, and Abilities:

· Strong interpersonal, communication, and organizational skills.

· Ability to work independently and adapt quickly to changing operational needs.

· Knowledge of healthcare admissions processes, payer authorization requirements, and referral management.

· Ability to travel nationally for extended periods of time.

· Ability to collaborate effectively with corporate and local leadership teams.

 

WORKING CONDITIONS:

Work is primarily indoors. National travel is required and expected to exceed 90%. Employee must have reliable transportation and ability to travel by air as needed. Must have the ability to charge expenses and complete expense reimbursement forms. Extended hours and irregular schedules may be required based on operational needs.

 

ORGANIZATIONAL DATA:

This is an exempt position supervised by the Business Development Educator with dotted line reporting responsibility to local leadership, including the DSI and CEO, when operating as a contributor within assigned markets.

 

Physical and Mental Requirements:

This job description is intended to describe the general nature and level of work performed by individuals assigned to this position. It is not intended to be an exhaustive list of all duties, responsibilities, or qualifications required. Employees may be required to perform other job-related duties as assigned to meet organizational, departmental, or patient care needs. Responsibilities and requirements may be modified at any time by PAM Health in its sole discretion.

About PAM Health

“At PAM Health, our culture is defined by the values we demonstrate every day. Every employee is expected to align their behaviors, decisions, and interactions with our core values. Not just in moments of recognition, but in their daily work routine. These values are the foundation of our mission, the standard for our performance, and the compass for how we treat patients, families, and one another. Upholding these principles is not optional; it is a shared commitment to excellence and healing.”

 

Respect Treating every patient, their family, our colleagues, and the communities we serve with regard and dignity, cultivating an environment where people feel cared for, appreciated, and valued.

 

Integrity Being trustworthy and accountable for consistently meeting superior standards of character, honesty, ethical behavior, and job performance.

 

Care with Compassion Demonstrating genuine care for our patients and colleagues through empathetic awareness of suffering and taking action to relieve it.

 

Teamwork Collaborating with our colleagues in alignment with our values, being present for others, and consistently meeting elite standards of personal and team performance.

 

Innovation Actualizing success by challenging the status quo, developing a culture of creativity, and committing to positive, transformational change.