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Rehab Therapy Utilization CoordinatorLocation: Hyattsville, MD Additional Locations:
Job Number: 854401 Date posted: 12/27/2019
For members of a defined population, the Rehabilitative Therapy Utilization Coordinator is responsible for assisting with coordination of appropriate cost-effective rehab services that enhance a member's quality of life, focus on a member's optimal level of independence, reduce inappropriate utilization of rehab services, and provide care in the most appropriate setting.
- In close collaboration with the multidisciplinary Health Care Team (KP Hospitalists, KP Rounders, KP Case Managers, UMOC Staff, Contracted hospital/SNF/Home Care therapy providers and KP internal PT Staff, etc) assesses the member's rehab status, functional status/limitations, response to treatments, resources, social support systems and environmental factors.
- Recommends, coordinates and evaluates a comprehensive rehab plan of care across the care continuum aimed at appropriate, quality care in the most appropriate and cost effective setting.
- Reviews and oversees the patient's rehab plan of care across the continuum of care utilizing comprehensive assessment tools, clinical pathways, outcome measurement tools. Identifies and analyzes trends and barriers that may affect patient outcomes. Identifies and advises corrections to deviations from clinical pathways.
- Provides utilization and referral management, referral reauthorization, and benefit interpretation to health care teams, UM MDs, service chiefs and other KFHPMAS staff as appropriate.
- Processes all assigned referrals including but not limited to rehabilitation therapies, home health care, and durable medical equipment.
- Identifies issues and barriers that may delay timely transition to the next level of care; communicate information to all affected parties.
- Ensures services are delivered in a manner that demonstrates high quality, is cost effective, and maintains high patient satisfaction.
- Ensures consistent and reliable documentation of activities in compliance with organizational standards. Maintains confidentiality of patient records and information.
- Provides education to members, families and caregivers, members of the health care team and the health plan staff.
- Facilitates the denial letter process in accordance to state and federal regulations.
- Serve as subject matter expert (SME) as requested by management for other health plan operations departments (Appeals, Provider Relations, Member Services).
- Contribute to the writing and revisions of organization's Medical Coverage Policies.
- Meets and exceeds individual and departmental performance standards.
- Other duties as assigned.
- Minimum six (6) years of experience as a staff Physical Therapist or Occupational Therapist required.
- Minimum one (1) year of experience in Acute and Rehab settings required.
- Graduate from an accredited Physical Therapy or Occupational Therapy Program required.
License, Certification, Registration
- Physical Therapy license or Occupational Therapy license in the appropriate jurisdiction required.
- National Provider Identification (NPI) required.
- Knowledge of Kaiser Permanente benefits, pay, and retirement plans.
- Utilization/outcome management experience preferred.
- Experience with computer software programs in a Windows environment preferred.
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.
About Rehab Services Careers
Rehab Services Careers
In an effort to increase our collective knowledge and deliver higher-quality, more informed care, we encourage dialogue and collaboration across the care delivery spectrum. Our rehab department includes professionals in audiology, respiratory care, physical therapy, occupational therapy, speech language pathology, and much more.
In addition to inpatient and outpatient opportunities, we also offer home health opportunities, affording you the chance to improve patient outcomes in the home care setting. With outstanding educational opportunities and modern equipment and technology, you'll actively participate in your patients' journey to wellness while continually elevating your own expertise.
Physical And Occupational Therapists
Kaiser Permanente offers full-time, part-time, per diem, and in-house registry opportunities in a variety of practice settings, including home health, inpatient, and outpatient. Additional opportunities include occupational therapist, physical therapist, and licensed physical therapist assistant.
At Kaiser Permanente, Respiratory Care Practitioners are an integral part of our respected health care team. They are responsible for developing patient treatment plans and have the opportunity to work in a variety of exciting and challenging areas from adult critical care to cardiology to high-risk delivery. Our Respiratory Care Practitioners have the advantage of computerized state-of-the-art equipment, including life support systems, arterial blood gas analyzers, and non-invasive monitors.
Kaiser Permanente's speech pathologists provide direct patient care to members with communication and swallowing disorders by evaluating, diagnosing, developing, and implementing therapy and treatment programs.
Our audiology professionals are a vital part of our rehab care team. They provide direction, counseling, and recommendations regarding the rehabilitation of hearing impaired patients.
See What People are Saying About Working at KP
Apr 17, 2019
"I love my job"
- Positive Outlook
I have been working at Kaiser Permanente part-time for more than 2 years
I’ve waited to get in to Kaiser for so long and now that I’m in, I’d never let go. I love people that i work with (although just like any other jobs, it has it’s highs and lows), i love my patients, pay is great and benefits are awesome!! Definitely 1 of the highest paying hospitals in the region.Full Review
Come introduce yourself to a member of the Kaiser Permanente team at an upcoming career or professional event. We look forward to meeting you in person.
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