Business Analyst Lead

General Summary Communicates with internal clinical team and third party payor to assess, develop, coordinate, advocate, and monitor a care plan that utilizes the patient's available resources in the most appropriate and cost effective manner. Responsible for the overall knowledge of the patient's plan of care, goals and objectives to ensure a smooth transition throughout the continuum. Consistently demonstrates support of the RIC statement ofMissionand Philosophy by striving for excellence, contributing to the team efforts and showing respect and compassion for patients and their families, fellow employees, and all others with whom there is contact at or in the interest of the institute. Principal Responsibilities Liaison for the team for pre-admission clinical and financial information. Educates team regarding patient financial benefits. Evaluates assessment information and assigns patients to the appropriate clinical path and monitors in conjunction with the physician and the clinical team. Validates the level of care. Disseminates pertinent family dynamics to the team. Serves as primary information and assures that special needs are met. Serves as primary coordinator of care. Oversees patient's function/medical status, facilitates team conference, has knowledge of patient/family and team goals, oversees ordering of patient equipment DME and supplies, ensures completion of treatment plan and D/C education, identifies self to patient/family within 24-48 hours of admission, and ensures completion/coordination of D/C plan. Monitors resource utilization. Monitors patient and family goal attainment relative to the interdisciplinary treatment goals and addresses the appropriateness of the level of care with the clinical team conferences. Initiates and maintains communication with external case managers, referring primary care physician and acts as a resource regarding available services at the Rehabilitation Institute of Chicago System. Initiates and maintains communication with external case managers and primary care physicians to obtain pre-authorization for ongoing rehabilitation needs and advocate for the patient to receive appropriate rehabilitation services. Communicates in the format defined by the third party payor. Negotiates any conflict arising with a third party payor representative on behalf of the patient and Institute during their rehabilitation program. OTHER RESPONSIBILITIES Participates in planning, development and execution of Rehabilitation Institute of Chicago sponsored educational programs and presentations to external physicians, clinical staff, acute care facilities, insurance groups, managed care organizations, corporations, and other appropriate groups. Reporting Relationships Reports to the Administrative Director for the appropriate facility/COG/Department. Knowledge, Skills & Abilities Required Work requires a professional level of knowledge in a specialized field of rehabilitation. Nursing care managers must have 2 years experience in rehabilitation nursing and have CRRN certification. Social work care managers must hold an MSW. Illinois license or certification in one's own profession. Analytical ability or certification in one's own profession. Knowledgeable in community resources, health care system and interdisciplinary functioning. Interpersonal communication and advocacy skills are required to work with patients and families, and various medical professionals within and outside of the Institute. Capable of learning and utilizing PC software to collect and analyze data and prepare and aggregate reports. Working Conditions Normal office environment with little or no exposure to dust or extreme temperature. Job Grade - RN14 #J-18808-Ljbffr