Referral Center RN, VNA of Cape Cod

Cape Cod Healthcare Barnstable, MA 02601, US

Purpose of Position: The position provides leadership, operational oversight, and hands-on management of referral intake, insurance verification, authorization, clinical reimbursement, and liaison functions for Hospice and Home Health services, in collaboration with the Executive Director. The role is responsible for supervising staff; establishing and maintaining standardized workflows; monitoring performance metrics; resolving operational and authorization issues; and ensuring efficient, compliant referral and intake operations. The position supports staff recruitment, onboarding, training, and performance management; serves as a subject matter expert for referral systems, EMR, and insurance portals; and acts as a primary resource for referral sources, insurance providers, and internal departments. The role is primarily based on-site to support staff supervision, daily operations, cross-departmental coordination, and coverage during staffing needs, while promoting regulatory compliance, service quality, and continuous process improvement.

Description

Identify, analyze and streamline referral/data entry processes, insurance verifications, authorizations for both Hospice and Home Health.
Provide direct operational and supervisory oversight of hospital liaisons supporting home health and hospice referral sources.
Serve as the primary operational point of escalation for hospital partners regarding referral issues, admission barriers, coverage concerns, and service availability.
Collaborate with hospital case management, liaisons, and physicians to strengthen referral relationships, to improve referrals and home health and hospice census.
Manage insurance benefits in the best interest of the agency and patients including resolving authorization and coverage issues.
Problem-solve complex authorization, payer and referral challenges to minimize delays in care.
Develop, implement and maintain standardized work processes within assigned departments to ensure efficiency, accuracy and consistency.
Establishment of departmental performance metrics and tracking systems’ monitor outcomes and identify opportunities for improvement for all assigned departments.
Conducts interviews and, hires and oversees on-boarding and orientation of new staff.
Conduct ongoing coaching, training and annual timely employee performance evaluations for assigned staff.
Manage PTO requests and staff schedules to ensure adequate coverage and operational continuity.
Educates staff on regulatory changes, workflow changes and organizational policies and procedures for Hospice and Home Health.
Conducts monthly staff meetings and weekly team huddles with assigned departments to support communication, accountability and performance.
Serves as a subject matter expert with e-discharge systems, insurance portals, electronic medical record (EMR) systems.
Act as primary resource and point of contact for referral sources and insurance providers for both Hospice and Home Health.
Provide onsite operational coverage as needed during staffing shortages including phones, faxes, electronic systems, referral entry and obtaining verification or authorization of insurance benefit
Communicate effectively with internal departments and Team Managers regarding referrals, availability of services, insurance benefit and authorization, scheduling and data entry issues
Maintain Alerts Reports in EMR to manage “NTUC” volume
Challenges current working practices; identifies process improvement opportunities and presents recommendations and solutions to management. Engages and commits to the organization’s culture of continuous improvement by actively participating, supporting, and promoting CCHC Pillars of Excellence.
Other duties as assigned

Qualifications

Bachelor’s Degree in a clinical field preferred but not required
Two years’ healthcare management experience preferred
Two years’ experience in homecare operations preferred
In-depth knowledge of disease management, financial and insurance reimbursement
Understanding of Home Health and Hospice regulatory requirements
Familiarity with electronic discharge management systems and EMR

Schedule Details: 37.5 Hours Per Week, Monday–Friday, 8a–4p, Rotating Weekends and Holidays Organization : Visiting Nurse Association

Primary Location : Massachusetts-Hyannis

Department : VNA-Hospice

Annual/Hourly: Unassigned

Hiring Pay Range: 0 - 0

Share this job

Related Jobs

Full-time

1 week ago

Registered Nurse (RN)

Plymouth Rehabilitation & Health Care Center Plymouth, MA

Plymouth Rehabilitation & Health Care Center, a 152-bed skilled nursing facility, is hiring full-time and part-time Registered Nurses! Hourly rate from $42 to $48 with weekly pay. Evenings, overnights, and weekends have shift differentials. Up to $5,000 sign-on bonus available!* Openings on all shifts. As a Registered Nurse, you provide direct nursing care to residents and supervise the day-to-day nursing activities performed by the nursing assistants to ensure that the highest degree of quality care is maintained at all times. Education and Experience: Must possess at least a nursing degree from an accredited school of nursing or college. Must be CPR certified. Must have a current and active RN license in the state, or be in the process of obtaining one. New graduates welcome! Duties and Responsibilities: Meet the nursing and rehabilitation needs of each resident. Maintain current resident care plans on all residents under his/her care. Renders and/or assists with complete nursing care, treatments, dressings, and other physician orders. Transcribe physician’s orders promptly and accurately. Review patient records daily to ensure accuracy and completeness. Document comprehensive and complete nursing notes. Visit each resident daily to evaluate resident needs. Maintain accurate awareness of residents on alert list. Document and report any unusual or significant findings; contact the physician when necessary. Administer medication according to procedure. Maintain an accurate and safe control of all drugs for which he/she is responsible. Complies with facility Privacy Practices Policies and Procedures and protects residents’ individual health information. Specific Requirements: Must be able to read, write, speak and understand the English language. Must possess the ability to make independent decisions when circumstances warrant such actions. Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel and the general public. Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long term care. Must possess leadership and supervisory ability and the willingness to work harmoniously with professional and non-professional personnel. Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies and procedures, etc., that are necessary for providing quality care. Must be familiar with drug actions and interactions. Must have knowledge of restorative nursing rehabilitation policies and utilizes appropriately. *Employment conditions apply Benefits: Competitive and Weekly Pay Holiday Pay for Hourly and Salaried Employees Overtime Pay for Hourly Employees Career Advancement Opportunities Exclusive Employer Discount Program Available for Eligible Team Members: Employer Paid Life Insurance 401(k) with Employer Match Vacation and Personal Time Health, Dental, and Vision Insurance We are an equal opportunity employer that values diversity at all levels. All individuals are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow federal and state guidelines regarding staff vaccinations. Our policy requires all staff to be up to date with COVID and flu vaccinations, or acknowledge a declination of the vaccination(s).

Infusion

Per Diem

2 weeks ago

Home Infusion RN

CureCare Marion, MA

To continue with your application, please complete a brief survey (approximately 5–7 minutes). For best results, we recommend copying and pasting the link into a separate browser. CureCare Are you looking for something new? Have you been spending long hours on your feet, rushing from patient to patient with no time to provide quality care? It's time for a change. Join CureCare, a trusted home infusion nursing provider that has been serving patients across the Northeast for over a decade. At CureCare, we value your expertise and offer a supportive work environment that allows you to make a meaningful difference in patients' lives. CureCare is searching for hardworking RNs to join our team of dedicated Home Infusion nurses. As a Home Infusion RN, you will have the opportunity to provide infusion therapy and nursing services to patients in the comfort of their own homes, ensuring the highest quality of care and patient satisfaction. With CureCare, you'll have a great deal of flexibility in your per diem role. Our nurses are expected to have at least 20 hours of availability per month to see patients. This position will require you to build your book of business; no hours are guaranteed.* Step away from the hectic pace of traditional nursing and experience the rewarding work of providing personalized care in a home setting. Join us at CureCare to experience a fulfilling work environment and make a difference in patients’ lives. Don't miss this opportunity to enhance your nursing career with a company that values your expertise and focuses on patient-centered care. Hourly Pay Range: Pay is based on experience. Responsibilities: CureCare’s nursing team provides best-in-class clinical care. As a member of the nursing team, you will: • Build rapport with patients, provide infusion therapy, education, and monitoring. • Establish and maintain vascular access devices as prescribed. • Administer medications, assess for side effects. • Maintain knowledge of infusion therapies. • Assess patient appropriateness for home infusion. • Document patient history and clinical information. • Provide skilled care as ordered. • Communicate patient response to care promptly. Why CureCare: Join CureCare as an infusion nurse and enjoy the perks: • Flexible work schedules • Reimbursement for travel expenses based on the IRS standard mileage rate • Digital nurse documentation • Incentivized nurse referral program • Convenient access to infusion materials, delivered directly to patients' homes • Supported by both CureCare's Clinical and Corporate Teams Qualifications: • Active and unrestricted RN licensure in state(s) of practice • Valid Driver’s License and ability to commute to patient’s house • Minimum 2+ years of general Infusion Experience in clinical care setting (e.g. medical surgical unit, emergency department, intensive care unit) • Ability to work independently in home • Able to complete nursing documentation using electronic medical record documentation • Proficient with peripheral IV insertion • Current CPR Certification • Covid vaccination preferred, but not mandatory • Home Infusion experience preferred

New Grad

Full-time

3 weeks ago

Graduate Nurse

Plymouth Rehabilitation & Health Care Center Plymouth, MA

We are hiring Graduate Nurses at Plymouth Rehabilitation & Health Care Center who are ready to start their nursing career! Shift openings include 7a-3p, 3p-11p, and 11p-7a with weekly pay! Hourly rate ranges from $40 to $46 for LPNs and $42 to $48 for RNs, depending on the shift. Here at Athena Health Care Systems, our employees are the heart of our organization, and we take immense pride in their dedication. We are not only committed to delivering high-quality care and customer service to our patients and their families, but we also aspire to be the employer of choice. We strive to create a workplace where your skills and talents are nurtured to allow you to grow within the company. Under the direct supervision of a licensed nurse, graduate nurses can begin providing care to residents while they wait to take their NCLEX. Education: Must have graduated from a Massachusetts board-approved nursing education program within one year of hire date. Can be for LPN or RN. What we will need: Documentation from your nursing program showing your graduation date. Proof of scheduled NCLEX licensure exam within 90 days of hire. What we will do: Our team will provide supervision and training under a licensed nurse to ensure you are comfortable with providing care. Your assigned tasks will not exceed your level of academic preparation or outside the scope of your competency level. Duties and Responsibilities: Meet the nursing and rehabilitation needs of each resident. Maintain current resident care plans on all residents under his/her care. Follow physician’s orders. Renders and/or assist with complete nursing care, treatments, dressings, and other physician orders. Transcribe physician’s orders promptly and accurately. Review patient records daily to assure accuracy and completeness. Document comprehensive and complete nursing notes. Visit each resident daily to evaluate resident needs. Maintain accurate awareness of residents on alert list. Document and report any unusual or significant findings; contact the physician when necessary. Administer medication according to procedure. Maintain an accurate and safe control of all drugs for which he/she is responsible. Initiate any and all emergency procedures as necessary. Demonstrate correct safety techniques in accord with orientation and training processes of Athena and your specific job description. Complies with facility Privacy Practices Policies and Procedures and protects residents’ individual health information. Other duties assigned by Director of Nursing and other managerial team members. Specific Requirements: Must be able to read, write, speak, and understand the English language. Must possess the ability to make independent decisions when circumstances warrant such actions. Must possess the ability to deal tactfully with personnel, residents, family members, visitors, government agencies/personnel and the general public. Must be knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to long term care. Must possess leadership and supervisory ability and the willingness to work harmoniously with professional and non-professional personnel. Must possess the ability to plan, organize, develop, implement, and interpret the programs, goals, objectives, policies and procedures, etc., that are necessary for providing quality care. Must possess accurate and comprehensive assessment skills. Must be familiar with drug actions and interactions. Must have knowledge of restorative nursing rehabilitation policies and utilizes appropriately. Must have patience, tact, a cheerful disposition, and enthusiasm, as well as the willingness to handle difficult residents. Must be able to communicate effectively to appropriate personnel regarding emergencies. About Athena Health Care Systems: Since its establishment in 1984, Athena Health Care Systems has pioneered the delivery of exceptional healthcare services. Operating nursing homes and hospice agencies across Connecticut, Massachusetts, and Rhode Island, Athena stands out as a healthcare leader in Southern New England. Athena’s Benefits: Competitive and Weekly Pay Holiday Pay for Hourly and Salaried Employees Overtime Pay for Hourly Employees Career Advancement Opportunities Exclusive Employer Discount Program Available for Eligible Team Members: Employer-Paid Life Insurance 401(k) with Employer Match Vacation and Personal Time Health, Dental, and Vision Insurance We are an equal opportunity employer that values diversity at all levels. All individuals are encouraged to apply. Athena Health Care Systems and its managed facilities/agencies follow federal and state guidelines regarding staff vaccinations. Our policy requires all staff to be up to date with COVID and flu vaccinations, or acknowledge a declination of the vaccination(s).

Urgent Care

Temporary

2 weeks ago

Urgent Care RN, Orleans (Summer Temp)

Cape Cod Healthcare Orleans, MA

$40 - $54 / hour

Purpose of Position: To provide professional nursing care and support for urgent care center patients receiving treatment and evaluation to all age groups. Description Under the direct supervision of the provider, the nurse will assist in initiating care in the Urgent Care setting. RN/LNP must correctly identify patients by asking name and date of birth. Nurse duties include intake, assessment, point of care testing, all provider ordered treatments, discharges, and patient education. Assess and treat patients in a fast paced, high volume urgent care setting. Obtain and document all current medical history, medications, and allergies within the EMR. Assist providers in urgent care procedures. Implement orders for EKG’s, dressing changes, suture removal, ear lavages, splinting, injections, IV insertion, and IV infusions. Maintain and stock all rooms, IV carts, and other supplies as needed to meet the needs of the department. Check all equipment to ensure proper working order. Return patient phone calls to answer general medical questions in a timely manner. Always maintain patient privacy and confidentiality of information. Assess personal and learning developmental needs and act as a resource person for other staff and patients. Participate in staff meetings and other activities that promote the growth and development of nursing and patient care. Work cooperatively with co-workers and communicate politely with department employees, patients, and visitors. Perform other work duties as requested. Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers. Qualifications Urgent Care RN – Grade P020, Job Code: P020 Graduate of an accredited School of Nursing (RN) - Currently licensed as a Registered Nurse in the Commonwealth of Massachusetts (BLS) - Current Basic Life Support certification Previous IV insertion/therapy skills Acute care experience (Preferred) - Bachelor’s degree in nursing (BSN) (Preferred) Previous Urgent Care/Emergency Department experience Urgent Care LPN – Grade 1P016, Job Code: 10566 (LPN) - Currently licensed as a Licensed Practical Nurse in the Commonwealth of Massachusetts (BLS) - Current Basic Life Support certification Previous IV insertion/therapy skills Acute care experience (Preferred) Previous Urgent Care/Emergency Department experience Schedule Details SUMMER TEMP, 36PP (18 Hours Per Week) Rotating Days, Mon-Fri, 8a-2p, Every Other Weekend 8a-2p, Occasional Holidays Organization : Medical Affiliates of Cape Cod Primary Location : Massachusetts-Orleans Department : MAC-Orleans Urgi Physician Annual/Hourly: Hourly Hiring Pay Range: 40 - 54

Manager/Supervisor

Part-time

2 weeks ago

Weekend RN Supervisor

Healthcare Nursing Center Marion, MA

Weekend RN Supervisor - Part-Time Position Job Summary: We are seeking a compassionate and experienced Registered Nurse to serve as a Weekend RN Supervisor at Sippican Rehabilitation and Healthcare Center, a renowned healthcare provider in Marion, MA. As a Weekend RN Supervisor, you will play a vital role in ensuring the delivery of high-quality resident care, supervising nursing personnel, and promoting a positive and inclusive work environment. Primary Responsibilities: • Direct, evaluate, and supervise all resident care, initiating corrective action as necessary • Make resident rounds with a report to the Director of Nursing Service • Conduct quality assurance and continuous quality improvement monitoring • Establish open lines of communication between all nursing personnel, consistently taking follow-up action as necessary • Counsel and discipline nursing personnel and recommend personnel action to the Director of Nursing Service as necessary • Review residents admitted, comparing physician orders with each resident's plan of care to assure appropriate implementation • Perform basic nursing skills with knowledge and competence • Collaborate with the interdisciplinary team to achieve exceptional patient outcomes Prerequisites: • Graduate of an accredited school of nursing • Current RN licensure in Massachusetts • Minimum of 3 years recent clinical experience • Knowledge of Geriatric Nursing • Current certification in Basic Cardiac Life Support in accordance with American Heart Association or American Red Cross standards • Knowledge of growth and development across the life span What We Offer: Competitive compensation package Part-time schedule, perfect for those seeking a balance between personal and professional life Opportunity to work with a dedicated and compassionate team How to Apply: If you are a motivated and compassionate Registered Nurse looking for a new challenge, please apply to this exciting Weekend RN Supervisor opportunity. We look forward to reviewing your application and discussing how you can contribute to our mission of delivering exceptional patient care. Apply Now