Care Management Discharge Coordinator

POSITION SUMMARY

Pay Range: $27.45/hr to $38.69/hr The Care management Discharge Coordinator, working as a member of the interdisciplinary team, provides assistance and support to the Case Management team. Helps facilitate a safe discharge plan, providing patients with services and resources as appropriate. Collaborates with the treatment team and the patient to create an appropriate plan based on the resources available. Activities are related to discharge plan coordination, insurance utilization to ensure hospitalizations are covered as well as external resources for discharge and general support of the department employees.

• Aids Case Management clinical team members in securing necessary post-acute care, DME, community resources and transportation for the various discharge needs of patients.
• Coordinates communication with physicians, clinics, community resources, patients and Case Managers regarding the continuum of care according to determined care plans.
• Provides timely and accurate information to payors, service partners, staff, patients and their families.
• Supports the coordination of utilization management, and discharge planning functions. Assists in discharge planning and coordinate placement of the patient.
• Researches and negotiates patient needs or other resources during discharge process.
• Communicates with third party payer case management and provides documentation as required.
• Collaborates with patients, families, physicians, nurses, and other health care professionals to facilitate post-hospitalization health care services.
• Assists in securing prior authorization from patient’s insurance provider for transition to level of care as deemed clinically appropriate to meet level of care needs.
• Discusses payer criteria and issues, on a case-by-case basis, with clinical staff and follows up to resolve problems with payors as needed.
• Determines the need for discharge planning resources within one (1) business day of being flagged for intervention.
• Supports RN Case Manager with execution of an individualized discharge plan that incorporates contributions from the multidisciplinary care team and addresses the discharge needs of patients along the continuum of care for the best possible outcomes.
• Facilitates the timely discharge of patients from the hospital setting from the discharge coordinator role perspective.
• Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
• Collaborates directly with Case Manager to facilitate appropriate discharge of patient.
• Facilitates referrals for home health care, hospice, medical equipment and supplies and transfer to other facilities as appropriate.
• Documents relevant discharge planning information in EMR according to department standards including all services arranged, referrals and continuous updates.
• Arrange or identify follow up appointments post-discharge including new, PCP, Specialties, lab, radiology etc. to prevent hospital readmissions.
• Provides motivated assistance in admissions, transfers, and discharges of patients managed by Case Management.
• Follow up with any services arranged such as referrals/insurance companies to ensure resources are obtained.
• Arranges patient transportation at the direction of clinical staff.
• Advocates and respects patients’ rights and/or significant other’s rights.
• Consults with the social worker to identify appropriate social service needs, and help facilitate referrals to appropriate outpatient services.

• Reviews Admitting/IVS comments in EMR, approved length of stay, clinical review due date, and insurance company UR contact information in Payer Communication of EMR to minimize miscommunication when coordinating resources
• Calls appropriate inside or outside personnel to locate missing authorization numbers, approved length of stay, clinical review due date, and insurance company UR contact information to ensure resources are covered for post-acute coordination
• Collects and organizes data related to clinical condition and treatment plan for use in utilization review by communicating with insurance providers. If denied, collaborates…