Posted in Other about 3 hours ago.
Summary
Work directly with pediatric patients (and their families) in the outpatient setting who are injured, ill, or newly diagnosed with a pediatric condition and who may experience altering changes in income, health insurance coverage, physical access to their home, specialized transportation, and caregiver assistance to maximize independent function in the community. Collaborate across the continuum of care and with the interdisciplinary inpatient and outpatient rehabilitation teams, community providers, and community agencies to promote the highest level of independent function and an active, productive and fulfilling life. Direct and assist patients and their families in the application process for federal, state, and private resources and provide access to specialized disability community resources.
Key Responsibilities
• Patient and family assessment is conducted per established guidelines.
• An individualized longitudinal plan of care is developed in collaboration with the interdisciplinary team, patient, and family, and community providers to maximize quality and cost-effective outcomes while incorporating patient and family goals, expectations, and preferences.
• Education is provided to the patient, family, and the interdisciplinary team regarding community resources and insurance benefits to support the most effective use of these resources to promote maximize and maintain independence.
• Advocacy is provided to meet the comprehensive needs of the patient and family and to promote quality cost effective outcomes.
• Assistance with income replacement, health insurance, transportation, and referrals to appropriate and available community resources is provided.
• Communication and coordination is actively promoted between members of the interdisciplinary team, the payer and the community to minimize fragmentation of services and to maximize outcomes; patient centered team meetings are planned and conducted when indicated.
• Assistance with problem-solving and availability as a resource to the outpatient clinicians is provided.
• Culturally competent care is displayed to identify the patient's cultural needs and incorporate them in the development of the longitudinal plan of care.
• Documentation is completed in adherence to department standards.
• Additional department, organization, or network activities are completed per established objectives.
PCC Organizational Values of Innovation, Collaboration, Accountability, Respect, and Excellence are upheld.