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Coordinator Post Acute
2 months ago
ABOUT NCH
NCH is an independent, locally governed non-profit delivering premier comprehensive care. Our healthcare system is comprised of two hospitals, an alliance of 700+ physicians, and medical facilities in dozens of locations throughout Southwest Florida that offer nationally recognized, quality health care.
NCH is transforming into an Advanced Community Healthcare System(TM) and we’re proud to: Provide higher acuity care and Centers of Excellence; Offer Graduate Medical Education and fellowships; Have endowed chairs; Conduct research and participate in national clinical trials; and partner with other health market leaders, like Hospital for Special Surgery, Encompass, and ProScan.
Join our mission to help everyone live a longer, happier, healthier life. We are committed to care and believe there's always more at NCH - for you and every person we serve together. Visit nchjobs.org to learn more.
JOB SUMMARY
The Post Acute Coordinator is a part of the case management team who is responsible for ensuring smooth and efficient transitions of care from the acute care setting at all NCH campuses to appropriate post-acute care services. This role puts a strong emphasis on patient experience. The post-acute coordinator works with patients, families, the health care team and post-acute providers to optimize patient outcomes and reduce readmissions by promotion of safe and effective continuity of care.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Other duties may be assigned.
Discharge Planning:
· In close collaboration with inpatient case managers and the interdisciplinary team, oversees discharge plans for patients transitioning from acute hospital care to post-acute care settings (e.g., skilled nursing facilities, home health, rehabilitation centers, hospice).
· Assess patient needs, preferences, and eligibility for post-acute care services, ensuring that discharge plans align with patient goals and clinical guidelines.
· Provide education to patients and families about post-acute care options, ensuring they understand their care plan, medications, and follow-up appointments.
Care Coordination:
· Serve as the primary liaison between the hospital, patients/families, and post-acute care providers to facilitate seamless care transitions.
· Coordinate with insurance providers, social workers, and case managers to ensure timely appropriate authorization and coverage for post-acute care services.
Patient Experience:
· Advocate for patient needs and preferences throughout the discharge planning and post-acute care process.
Quality and Compliance:
· Ensure that all discharge and post-acute care plans comply with hospital policies, accreditation standards, and regulatory requirements, including those set by CMS and other governing bodies.
· Participate in quality improvement initiatives aimed at reducing readmissions, improving patient satisfaction, and enhancing care coordination.
Documentation and Reporting:
· Evaluates orders and medical record process to ensure safe post-acute care transitions.
· Reviews readmissions with post-acute providers to identify opportunities for improvement.
· Monitors and reports on key performance indicators related to post-acute care transitions, such as readmission rates and patient outcomes.
· Reports findings to readmission quality team.
Professional Development:
· Stays current with best practices in post-acute care coordination, discharge planning, and transitional care.
EDUCATION, EXPERIENCE AND QUALIFICATIONS
· Bachelor's degree in health-related field. Master’s degree preferred.
· Minimum of 3 years of experience in case management, discharge planning, or care coordination in an acute or post-acute care setting.
· Experience working with diverse patient populations, multiple payers, prior authorizations and the complexities of post-acute care services.
· Strong knowledge of post-acute care options, including long-term acute care, skilled nursing facilities, inpatient rehabilitation facilities, hospice and palliative care.
· Excellent communication, interpersonal, and organizational skills.
· Ability to work autonomously but collaboratively with interdisciplinary teams and external providers.
· Proficiency in using electronic health records (EHR).
