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Rehab Services

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Rehab Therapy Utilization Coordinator

Location: Hyattsville, MD Additional Locations:
Job Number: 854401 Date posted: 12/27/2019
Description:

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.



Essential Functions:
- 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.

Basic Qualifications:
Experience
- 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.
Education
- 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.
 
Additional Requirements:
- Knowledge of Kaiser Permanente benefits, pay, and retirement plans.



Preferred Qualifications:
- Utilization/outcome management experience preferred.
- Experience with computer software programs in a Windows environment preferred.

Primary Location: Maryland,Hyattsville,New Carrollton Administration 4000 Garden City Dr. Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun Working Hours Start: 8:30AM Working Hours End: 5:00PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Individual Contributor Job Category: Rehab Services Department: Utilization Management Operations Center Travel: No Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

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.

Respiratory Care

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.

Speech Pathology

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.

Audiology

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.

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