Care Management Discharge Coordinator

6 days ago


Hillsboro OR USA, United States Hillsboro Medical Center Full time
Job Summary

We are seeking a highly skilled Care Management Discharge Coordinator to join our team at Hillsboro Medical Center. As a key member of our interdisciplinary team, you will play a vital role in ensuring a smooth and efficient discharge process for our patients.

Key Responsibilities
  • Aid the Case Management clinical team in securing necessary post-acute care, DME, community resources, and transportation for patients.
  • Coordinate communication with physicians, clinics, community resources, patients, and Case Managers regarding the continuum of care.
  • Provide timely and accurate information to payors, service partners, staff, patients, and their families.
  • Support the coordination of utilization management and discharge planning functions.
  • Assist in discharge planning and coordinate placement of patients.
  • Research and negotiate patient needs or other resources during the discharge process.
  • Communicate with third-party payer case management and provide documentation as required.
  • Collaborate with patients, families, physicians, nurses, and other healthcare professionals to facilitate post-hospitalization healthcare services.
  • Assist in securing prior authorization from patients' insurance providers for transition to a level of care deemed clinically appropriate.
  • Discuss payer criteria and issues on a case-by-case basis with clinical staff and follow up to resolve problems with payors as needed.
  • Determine the need for discharge planning resources within one business day of being flagged for intervention.
  • Support 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.
  • Facilitate the timely discharge of patients from the hospital setting from the discharge coordinator role perspective.
  • Seek consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
  • Collaborate directly with Case Manager to facilitate appropriate discharge of patients.
  • Facilitate referrals for home health care, hospice, medical equipment, and supplies and transfer to other facilities as appropriate.
  • Document 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.
  • Provide 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.
  • Arrange patient transportation at the direction of clinical staff.
  • Advocate and respect patients' rights and/or significant other's rights.
  • Consult with the social worker to identify appropriate social service needs and help facilitate referrals to outpatient services.
Utilization Management
  • Review 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.
  • Call 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.
  • Collect and organize data related to clinical condition and treatment plan for use in utilization review by communicating with insurance providers. If denied, collaborate with treatment team to create a new plan.
  • Fax clinical information to third-party payers, when allowed by payer, to obtain authorization for continued stay and discharge resources.
  • Notify Case Manager when phoned clinical information is required, otherwise, resources are determined and coordinated based on coverage.
Requirements
  • Two years of healthcare delivery system-related experience.
  • Knowledge of community health and social service resources.
  • Bilingual skills a plus.
Working at Hillsboro Medical Center

Hillsboro Medical Center is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to providing a work environment that is inclusive and respectful of all employees and patients.


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