Discharge Planner Per Diem Days
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.
Assists patients through the healthcare system 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.
Provides education to patient and/or family in the use of equipment as needed
Attends Physician or Bedside Rounds as directed by the Case Manager or CM Manager
May be requested to perform data collection or provide reports
Take the initiative with delivering care
Assist with higher level of care
Performs other duties as assigned.
High school diploma or GED required
Medical Assistant Training preferred
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
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
Discharge Planner Per Diem Days in los angeles at Unknown Company
This position is listed as contract and onsite.