Discharge Planner - Care Management Full Time

If you are interested please apply online and send your resume to [email protected]

POSITION SUMMARY

Manages the discharge / transition process by working closely with the patient and / or family, and coordinating care with the multidisciplinary team : including physicians, nursing, and community based organizations, to ensure patient's adequate post-acute care transition.

Applies substantial knowledge and experience to perform a wide range of advanced activities and / or determines how to use resources to meet schedules and organizational goals;

serves as lead for team or work group.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Assists patients through the healthcare system, under the direction of CM, by operating as a patient advocate and health systems navigator.
• Coordinates continuity of patient care with external healthcare organizations and facilities.
• Obtains patient choice for post-acute facilities as required by CMS Conditions of Participation.
• Coordinates referrals to post-acute facilities, including home care, DME, SNF, LTAC, Acute Rehabilitation based on patient / family choice when patient has Medicare.
• Coordinates referrals to contracted facilities and vendors for managed care.
• Reports care / discharge barriers to appropriate care manager.
• Follow the continuum of patient care for admission to post-discharge.
• Communicates with patients and families with regard to transition plans, as directed by the Care Manager.
• Promotes clear communication amongst interdisciplinary care team members by ensuring awareness regarding patient care plans.
• Coordinates special needs and projects as assigned (resource manuals, complex placement, recuperative care)
• Knowledge of Medicare guidelines for post-acute needs IE : oxygen, wheelchairs, PT / OT / ST, feeding supplies
• Documents in the patient’s medical record for continuum of care.
• Coordinates transportation arrangements according to insurance requirements or as needed to meet post discharge needs
• Assists with post-acute needs as requested by CM Leadership or RN Case Manager.
• Performs other duties as assigned.

POSITION REQUIREMENTS

A. Education

• High school diploma or GED required
• Medical Assistant Training preferred

B. Qualifications / Experience

• Two (2) years continuous recent experience in a healthcare setting as unit clerk / care coordinator or similar position required.
• A team player that can multitask and can follow details knowledge of CMS guidelines preferred
• Highly organized and well developed oral and written communication, problem-solving, and decision-making skills

C. Special Skills / Knowledge

• Current Basic Life Support (BLS) for Health Care Providers from the American Heart Association
• Proficient to expert computer skills utilizing Microsoft Office especially Word and Excel
• Critical thinking
• Resourcefulness
• Bi-lingual Spanish preferred but not required
• Medicare conditions of participation, general knowledge of Title XX11 benefits for medi-cal recipients
• Must complete annual Workplace Violence Prevention Program / Certificate, per hospital policy, during initial training / orientation but not to exceed 30 days from hire / transfer.

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