Discharge Planner FVR
4 weeks ago
Updated: Apr 12, 2024
Location: Fountain Valley
Job Type:
Department: Case Management-FVR
Position Summary:
Working under the direction of the RN Case Manager, the Discharge Planner completes referrals for post-acute services for patients and assists with tasks that do not require a clinical license or degree. The Discharge Planner's responsibilities include the following activities:
a) arrange post-discharge services b) create and follow up on electronic referrals using the Tenet Case Management system, c) review patient choice letters with patients/families for required signatures, d) provide follow up Important Message to Medicare patients prior to discharge, e) communicate with patients, families and other members of the care team, f) complete tasks assigned by Case Manager, g) make copies, send faxes and complete phone calls, h) complete process reviews or audits as requested, and i) other duties as assigned.
Essential Duties:
1. Project a professional demeanor when working with other departments, medical staff, and nursing administration, guests of the hospital and outside agencies.
2. Verify demographic information with patient/family as directed by Case Manager.
3. Assist Case Manager with paperwork, copying, faxes and answering phones.
4. Assist the CM with referrals for post discharge services:
a) Verifies eligibility and benefits for each referral for home health, durable medical equipment,
Skilled nursing, acute rehab, and transportation if necessary.
b) Makes referrals for post -acute discharge services: Home Health, SNF, DME, Hospice, and transportation under the direction of the Case Manager.
c) Copies and faxes additional information as required for referrals.
d) Carry centralized cell phone from office and answer calls as appropriate.
e) Monitor request activity for messages sent by facilities and vendors and take appropriate action to complete the discharge process, i.e. faxing additional information if requested, sending responses to subscribers as to date, time and mode of transportation used to complete discharge.
f) Discuss problems, barriers to discharge and delays with Case Manager.
g) Collaborate with Case Managers to resolve problems as needed.
h) Order transportation and any DME needed.
i) Re-submit additional referrals if necessary.
j) Notification of placement to other responding facilities or agencies when patient placed.
5. AllScripts - Document all discharge planning updates DCP note as needed, at a minimum of every seven days.
6. Other Position Accountabilities:
a) Must be dependable and punctual.
b) Discuss and document that the Case Manager is aware of all discharge plans.
c) Acts as a resource in assisting others with case management objectives as appropriate.
d) Good, clear, and effective verbal and written communication skills.
e) Must function as a member of a team.
f) Must be able to adapt to a highly changeable environment.
g) Must be able to work consistently and effectively in complex situations.
h) Able to correctly follow instructions.
i) All other duties as assigned.
7. Position Specific Responsibilities:
Utilization Management
* Validates patient's demographic and payer information with patient/family and notifies Patient Access immediately if any corrections are needed
* Validates that all commercial/managed care discharges have an authorization for status and level of care provided and notifies Director of Case Management (DCM) of variances
* Provides Important Message follow up letter and Outpatient Observation Notification to Medicare beneficiaries per Tenet policy and under the direction of the RN Case Manager
Transition Management
* Makes referrals for post-acute services under the direction of the RN Case Manager utilizing AllScripts
* Provides patients and families with choices of post-acute providers per Tenet policy
* Responds to post-acute providers timely and completes referrals per Tenet policy
* Documents and communicates all elements of the post-acute referral to the RN Case Manager and the healthcare team, patient/family and post-acute providers
* Completes tasks as assigned by RN Case Manager
* Makes copies, send faxes and complete phone calls to arrange post-acute services and to ensure that appropriate hospital information is communicated to post-acute providers
* Documents all referrals and tasks in the Case Management Documentation system per Tenet policy
8. Specific to PEDS/PICU/NICU:
* Ensure collaboration between multidisciplinary team members and communication with the primary care physician, community agencies, CCS programs, CCS Special Care Centers, Medical Therapy Units (MTU), Medi-Cal In-Home Operation Units, and Regional Centers whose services may be required and/or related to the care needs of the infant, child or adolescent after hospital discharge
* If the patient does not have a primary care physician, the Discharge Planner will coordinate with the insurance company to obtain a primary care physician as well as make a follow-up appointment. Communication of this appointment will be shared with the patient's family.
* Ensuring that each patient discharged from the unit have follow-up by a primary care physician and a specialized program of care, as applicable, in the follow-up care of the patient, i.e., rehabilitation services.
* Discharge planner with coordinate family conferences with the multidisciplinary team for the medically fragile and/or complex.
* The Discharge Planner will coordinate in-depth placements to post-acute care referral agencies such as long-term acute care as well as sub-acute agencies and regional center.
* The Discharge Planner will coordinate with insurance companies and pharmacies to ensure authorization is obtained for high cost medications upon discharge.
Education and Experience
Required: High school diploma or equivalent. Required skills and abilities: Word processing skills necessary. Knowledge of medical terminology. Excellent communication skills, both verbal and written. Maintains confidentiality, tact and diplomacy. Preferred: UR/UM process within hospital, insurance company or medical office environment, hospital. Admitting process experience or SNF admitting process.
Mandatory
Hospital Mandatory Education Requirements: Orientation, Environment of Care, OSHA, Infection control, Abuse/Neglect, Ethics, etc.
Requirements
Tuberculosis Screening
Mask Testing
Other (describe): Immunizations & Flu Vaccine
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