Transitional Care Navigator Job at Bedrock Management Services Organization

Bedrock Management Services Organization Atlantic County, NJ

Bedrock Management Services Organization, LLC

Job Description

Position Title: Transitional Care Navigator
Reports to: Director of Transitional Care Management
Category: Exempt
Department: Business Development

Position Summary: Bedrock Management Services Organization, LLC (MSO), Transitional Care Navigator (TCN) primary objective is to support its client healthcare provider practices. This will be accomplished by collaborating with discharge planners, case managers, clients, professional resources and families at designated facilities within an assigned territory to coordinate the initiation of appropriate health care services. The TCN is responsible for overseeing the quality of care as the patient transitions through the healthcare system. The TCN is responsible for establishing and developing new community and provider relationships. This position provides continued support to the MSO’s customers, including medical practices and its providers, senior living communities, acute care hospitals, and post-acute care centers.

Essential Functions:
  • Support physician practices enrolled in the MSO with strategic business development goals
  • Identify healthcare entities and practices that would benefit from enrolling into the MSO
  • Develop relationships in accordance with the MSO’s core values with referral sources, physicians, and other health care professionals
  • Identify new partner opportunities as well as trends to support business and revenue growth
  • Plan and organize marketing meetings/events and continuing educational seminars with professional partners
  • Market and sell services offered by the MSO
  • Market and sell services offered by the Provider Practices within the MSO
  • Work with acute health care partners to help with patient transitions to post-acute care, senior living, and long-term care
  • Meet with patients and families, as requested, to ensure smooth transitions from hospital to contracted healthcare facility
  • Work closely with center/organization’s administration and admissions teams to ensure patient referral conversions
  • Assist with the review/screening of new patient referral clinical information for appropriateness
  • Schedule and attend meetings with hospital and healthcare partners to maintain and grow relationships as well as uncover areas for process improvement
  • Promote MSO client provider services to medically qualifying patients and their family members or caregivers
  • Promote MSO Client provider discharge services to acute and post-acute care centers

  • Ensure prior to patient discharge from post-acute care that medically eligible patients are set up with RPM (remote patient monitoring) and other valuable final products through participating medical practice
  • Work closely with the MSO’s practice providers in relation to patient care needs and appropriateness
  • Identify and inform MSO’s Director of Transitional Care Management about market trends, changes, and barriers
  • Maintenance of strong relationship with accounts in assigned territory
  • Perform as a team player with colleagues
  • Complete weekly activity log
  • Track and maintain referral, admission, new business data

Non-Essential Functions:
  • Attends all required training, in-services, and staff meetings
  • Strives to maintain a safe working environment for the prevention of accidents, the preservation of equipment, and the achievement of safe working practices and by practicing proper infection control measures while in centers
  • Maintains a positive, professional demeanor toward residents, visitors, families, coworkers, and professional partners
  • Adheres to all policies and procedures of Bedrock Management Services Organization, LLC.
  • Performs other duties as assigned
  • Professionally represents the MSO during meetings, center visits, and video calls

Experience and Education:
  • Minimum of 2 years' experience in healthcare sales and business development
  • 1 year Experience with care coordination preferred
  • Ability to explain moderately complex information clearly to enhance customer understanding
  • Excellent interpersonal, communication, decision-making and facilitation skills
  • Ability to work independently and under pressure in a complex and changing work environment
  • Proficient in computer skills and knowledge of software applications, including programs, such as PCC, Extended care, Epic, Microsoft Office Products
  • Ability to multitask and prioritize
  • Discharge planning and external liaison experience is a plus

Valuable Final Products:
  • Referral of Nursing Facilities to Medical practices for rounds

o 3 Nursing Home intro meetings to Senior Team per Month

  • Referral of assisted/independent living facilities

o 3 new assisted/independent living facility meetings to Senior Team per Month

  • Opening new acute care centers

o 1 new acute care center and/or referral source per month

  • Referred Physician and Mid-level providers for practice interviews

o 3 referred providers for interview per month

  • Provider Services (from acute, post-acute, and other referral sources)

o Remote Physiological Monitoring

§ 10 per week

o Therapy Services (once applicable)

§ 5 per week

o Telehealth Visits

§ 10 per week

o Home Care referrals

§ 5 referrals (bonus if they convert)


Physical Requirements: Standing (under 1/3), walking (under 1/3), using hands to finger, handle or feel (over 2/3), reach with hands and arms (over 2/3), climb and balance (under 1/3), stoop, kneel (under 1/3), talk or hear (over 2/3), taste or smell (under 1/3), Lift up to 10 pounds (1/3- 2/3), Up to 25 pounds (under 1/3), Up to 50 pounds (under 1/3)

Requirements Other: Employee must maintain a home/remote office space that is professional and secure. This job will require both field and remote office work.




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