DISCHARGE PLANNER

Job Summary

Responsibilities

• Promote the mission, vision, and values of the organization.
• Identifies patients for teaching, discharge, and extended care facility needs.
• Collaborates with physicians, caregivers, patient, family, other departmental team members, and payor to proactively develop and implement a safe and appropriate discharge plan.
• Participates in team meetings that foster interdepartmental collaboration with the patient and their family as deemed necessary, this includes multidisciplinary meetings and Utilization Review/Case Management meetings.
• Provides input in such meetings regarding utilization management and discharge planning.
• Applies utilization review criteria to assess and document the appropriateness of admission, continued stay, level of care, and readiness for discharge; refers cases that do not meet criteria to Case Management Director and/or Medical Staff.
• Maintains working knowledge of Medicare, Medicaid and private insurance company coverage for referred products and services.
• Communicate daily with admissions personnel regarding admissions and discharges to various facilities.
• Ensures that a quality of care is maintained or surpassed by collecting quality indicators and variance data and reporting the data to the appropriate department; reports and identifies data that indicates potential areas for improvement of care and services provided within the system.
• Knowledgeable of patient’s financial status, diagnosis and discharge needs and documents these as an ongoing review.
• Absorb referrals, prior authorization for Home Health Care, DME, SNF, acute rehab and appointments.
• Maintain a current list of resources for referrals and refers to the appropriate inpatient, outpatient and community resources.
• Participate in and complete discharge assessments, complete follow up phone calls in a timely manner and provide referrals/ data according to the patient’s needs.
• Participate and communicate with the care team in management of the patient through the program.

Experience & Skills Needed

• Ability to maintain patient confidentiality at all times.
• Knowledge of Utilization management principles, HCFA guidelines, Swing Bed, home health care, skilled nursing facilities/long term care and durable medical equipment is highly desirable.
• Knowledge of nursing services and insurance coverage preferred.
• Strong organizational and interpersonal skills.
• Ability to determine appropriate course of action in more complex situations.
• Ability to work independently, exercise creativity, be attentive to detail, and maintain a positive attitude.
• Ability to manage multiple and simultaneous responsibilities and to prioritize scheduling of work.
• Ability to maintain confidentiality of all medical, financial, and legal information.
• Ability to complete work assignments accurately and in a timely manner.
• Ability to communicate effectively, both orally and in writing.
• Handle difficult situations involving patients, physicians, or others in a professional manner.