Discharge Planner- CASE/UTILIZATION MANAGEMENT - FULL TIME in Harlingen, TX at Harlingen Medical Center

Date Posted: 8/3/2019

Job Snapshot

Job Description



Overview

Responsible for the coordination of the various activities of the Case Management Department under the direction of the assigned Case Manager/Social Worker assist with development and implementations of discharge plans. Assists with case management referrals and authorizations. Maintains and coordinates Medicaid state submission forms for presentation to on-site reviewer and files them accordingly or as per facility’s procedure. Assists with Discharge Planning as assigned by interviewing patients/families and gathering data to develop a safe patient-focused Discharge Plan. 

Understands and is able to incorporate hospital philosophies into the department’s operational plan and goals, and assures staff members understand philosophies.Comprehends and adheres to industry standards and regulatory requirements: including, but not limited to, TJC, HFAP, CMS, accreditation standards, regulatory requirements, HIPAA, medical staff regulations, and hospital policies.Demonstrates knowledge of all types of payer systems, including but not limited to Medicare and Medicaid.  Assist CM/SW in obtaining insurance and other related information.                                                             Integrates with all care centers in hospital, addressing a variety of age-specific concerns.  Recognizes and addresses the psychosocial, cultural, and spiritual needs of patients and significant others, as evidenced by the discharge plan.Demonstrates knowledge of and participation in Performance Improvement activities.

Responsibilities

Provides discharge planning services including referrals for Home Health services, durable medical equipment, nursing facilities, transportation, and a wide range of other referrals.Assists case managers with initial discharge interview of inpatient admissions.Assists case managers with arranging DME, home health, transportation and SNF placement.Assists case managers in completing discharge planning assessments.Follows Hospital policies and other regulations regarding discharge planning protocols including offering patients a choice of discharge planning services and documenting interventions thoroughly and appropriately.Refers to Social Workers, Case Managers, and other hospital personnel appropriately regarding collaborating on a task, or when recognizing a certain task to be out of the discharge planner’s scope of practice.Assists with general office duties, e.g., copying, faxing, mailing, filing, data entry, etc.Attends and participates in regularly scheduled staff meetings including other department required meetings and educational programs. Assists with discharge planning, including meeting with patients/families to gather basic data and formulate an initial discharge plan.Functions and collaborates with readmission reduction team goals.Performs other duties as assigned or required.

Qualifications

  • Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non-managed care environments.

  • Experience in basic to intermediate computer skills/knowledge

  • Current BCLS (AHA) certificate required upon hire and maintain current.

  • Facility Specific Requirements (facility may require items listed below):

     

    High School diploma required.

    Associates degree or LVN license preferred.

    Experience in the hospital setting preferred.

     

    We are an Equal Opportunity/Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics.  If you need special accommodation for the application process, please contact Human Resources.  EEO is the Law: http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf