Discharge Planning Care Coordinator

Description

Wage Range: $27.88 - $44.61 per hour

• Social Workers provide crisis intervention, behavioral health and chemical dependency assessments, screen for abuse and neglect, as well as coordinate post-discharge care. We help coordinate with skilled nursing facilities, home health, hospice, arrange for equipment, and arrange for additional services in the community. 
• Utilization Management/Case Management Nurses provide clinical information to our payers and ensure that patients are meeting medical necessity for acute services.  They also partner with the Social workers in coordinating post-discharge care.
• Clinical Documentation Specialists review documentation to ensure that the patient experience is being documented accurately.  They partner with the physicians to reflect the appropriate severity of illness and level of service provision.

1. Coordinates and facilitates communication between EvergreenHealth and stakeholders including patients, families, community partners such as skilled nursing facilities (SNFs), Adult Family Homes (AFHs), Home and Community Services (HCS), vendors and other post-acute resources
2. Performs assessments of patients prior living situation, barriers to discharge, and resource needs upon discharge
3. Assists in facilitating needed discharge resources including helping patient complete applications, delivering durable medical equipment (DME), resource sheets, clothing etc.
4. Assists patients in coordinating transportation for discharge from the hospital.
5. Responds to requests from the interdisciplinary team in support of facilitating patient’s safe discharge from the hospital
6. Supports prior-authorization requests for post-acute services.
7. Provides regulatory notices including, but not limited to Important Messages, Observation notices and associated handouts as directed by RN Case Manager and/or Clinical Care Manager-Social Worker
8. Receives direct phone calls and/or voice mail messages and follow up as appropriate.
9. Works within multiple EMR and support tool systems and maintains confidentiality.
10. Practices fiscal stewardship in the role to ensure resources are appropriately utilized.
11. Completes special projects as assigned within scope of training and experience with direction and assistance of the Director, Manager or designee
12. Performs other duties as assigned.

• Bachelor's degree in Social Work, Psychology, Public Health, Health Administration or other relevant field.
• One (1) year of progressively responsible experience in office or general administrative work
• Current Healthcare Provider BLS certification by date of hire, per department standards
• Excellent customer service
• Excellent written, verbal, visual, and aural skills to effectively communicate and process information regarding patients, internal and external customers.
• Ability to multi-task and work well under stress
• Possesses excellent organizational skills and attention to detail
• Ability to function independently and to organize work and establish priorities

• Prior work with Epic EMAR
• Experience in a medical setting
• Knowledge of community resources and referral process
• Familiarity with medical terminology

• Medical, vision and dental insurance
• On-demand virtual health care
• Health Savings Account
• Flexible Spending Account
• Life and disability insurance
• Retirement plans (457(b) and 401(a) with employer contribution)
• Tuition assistance for undergraduate and graduate degrees
• Federal Public Service Loan Forgiveness program
• Paid Time Off/Vacation
• Extended Illness Bank/Sick Leave
• Paid holidays
• Voluntary hospital indemnity insurance
• Voluntary identity theft protection
• Voluntary legal insurance
• Pay in lieu of benefits premium program
• Free parking
• Commuter benefits