General Summary of Position
Ensures patients receive the right level of care at the right time. Responsible for working with the patient / family and extended healthcare teams to promote a smooth, efficient and customer-focused coordination of care from the time a case is scheduled through the acute care and post-acute care continuum.
Enhances the patient experience through effective and efficient patient care coordination using established criteria to determine the appropriateness of pre-and post-acute services.
Works with the patient / family, physician, inpatient case managers and other MedStar Health care providers to determine the most applicable post-acute environment(s) facilitating timely and medically appropriate discharge and transfer from the acute care hospital.
Primary Duties and Responsibilities
- Adheres to policies, procedures, quality standards, and safety standards of each of the hospitals and MedStar entities with which they are assisting with patient throughput.
- Collaborates with the extended PAT team, referring and attending physicians, health care professionals, case management and the patient / family to develop and facilitate pre-operative care as needed and a post-acute care plan.
- Communicates with the patient, their caregivers, physicians, hospital case managers, health care professionals and other team members to facilitate a smooth and timely transition of the patient through pre-operative preparation, acute and post-acute care.
- Contributes to the achievement of established goals and objectives of MedStar Health by assisting with the transition of care along the MedStar care continuum our community partners.
Complies with governmental and accreditation regulations. Completes annual Code of Conduct, Compliance, and other mandatory training.
- Coordinates the services for appropriate pre-surgical preparation and post-acute care plan in cooperation with appropriate MedStar associates and businesses.
- Educates patients / family, physicians, and other referral sources on the pre-surgical and post-acute care programs, services, and the care coordination process.
- Follows through on assignments. Punctual and manages own time well. Monitors progress toward achievement of goals within established parameters.
Pays attention to details. Utilize data to solve business problems.
- Informs and educates patients / families on the pre-surgical and post-acute plan of care and what to expect throughout the transition from one level of care to another.
- Maintains ongoing relationships with physicians and other referral sources and contributes to creating an environment of teamwork and trust among all associates.
- Offers patients / families a choice of pre and post-surgical services and providers in determining the final plan of care and appropriately documents that choice in the patient's medical record.
- Uses professional knowledge to shape care planning and coordination in partnership with patients and families.
- Participates in multidisciplinary quality and service improvement teams as appropriate to advance the post-acute care coordination process.
Participates in meetings, serves on committees, and represents MedStar Health in community outreach efforts as appropriate.
- Participates in the development, coordination and ongoing evaluation of patient education programs and materials.
- Performs daily routines including monitoring daily census and surgical schedules, attending appropriate unit rounds, keeping detailed daily logs / statistics regarding patients being followed, keeping workload organized and prioritized.
- Performs other duties as assigned.
- Utilizes technology to effectively maximize efficiency, accuracy, and communication of referrals.
- Actively engages in continuous improvement opportunities relevant to the department and MedStar Health. Is proactive in developing good workflow practices.
Minimum Qualifications
Education
- Nurses : BSN required
- Master's degree for Therapists required
Experience
3-4 years Nursing or therapy experience or equivalent required
Licenses and Certifications
Valid RN or Physical / Occupational Therapy License in Maryland, the District of Columbia or Virginia as appropriate for respective MedStar facility required
Knowledge, Skills, and Abilities
- Excellent verbal and written communication skills.
- Basic computer skills required.
- Demonstrates leadership skills, including self-initiative and the establishment of efficient and effective organization and process for planning, directing, problem-solving, and teambuilding.
This position has a hiring range of $72,758 - $123,260
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