group
Category
Administrative Support
business
Department
Case Management Social Services
date_range
Schedule
Full Time
schedule
Shift
Day
timer
Hours
8 Hour Shift
place
Location
Rancho Mirage, CA 92270
info
Job #
R0256376
  • Job Objective: A brief overview of the position.
    • The position is responsible for linking patients with community care providers to coordinate inpatient and post-acute care for complicated, high-risk cases of the medical center.  Primarily focused on out of area, uninsured/underinsured, TB, Dialysis, Infusion, IEHP and other high-risk patients.  
  • Reports to
    • Manager, Social Work and Discharge Planning Coordinators
  • Supervises
    • N/A
  • Ages of Patients
    • Neonate/ Infant
    • Pediatric
    • Adolescent
    • Adult
    • Geriatric
  • Blood Borne Pathogens
    • Minimal/ No Potential
  • Qualifications
    • Education
      • Preferred: Associates Degree in related field; 5 years of related experience may be substituted for education qualification
    • Licensure/Certification
      • Preferred:  certification(s) related to discharge activities such as listed in Essential Responsibilities 
    • Experience
      • Required: at minimum, 7 years discharge planning in a hospital setting with demonstrated increase in responsibilities in a lead or management position
      • Preferred: Background in case management
      • Preferred: Serving as liaison between health care providers
      • Preferred: Working with financial aspects of healthcare providers and insurances
  • Essential Responsibilities
    • Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
    • Assists in the identification of the need for (and implementation of) safe discharge plans for complicated, high-risk cases requiring advanced discharge planning interventions.
    • Works closely with the management team of Case Management in identifying complicated cases via:
      • Participation in Case Management Department daily rounds “morning huddle” meeting
      • Participation in weekly department Outlier meeting
      • Participation in unscheduled complex case team care conferences
      • Participation in IEHP High Risk Patient meetings
    • Works closely with the case management team to identify issues that may become barriers to discharge, such as homelessness, placement needs and medical care and addresses them in a timely manner.
    • Works closely with the medical team to identify issues that may become barriers to discharge, such as multiple co-morbidities, non-compliance with medical care, and addresses them in a timely manner.
    • Concentrates patient care efforts on patients who require dialysis by screening, evaluating acuity, arranging care for co-morbidities, arranging chair times according to payor, provider, geographical area and transportation resources.
    • Attends daily morning Bed Board meetings to proactively identify complicated needs of pending admissions.
    • Identifies and fulfills the needs of under- and un-insured patients via:
      • Working closely with Patient Financial Services, Health Advocates to determine and coordinate obtaining insurance patients may qualify for
      • Working with insurance companies to determine payment options such as letters of agreement
      • Maintaining up-to-date knowledge and educating multi-disciplines of policy changes and regulations that may impact payor reimbursement practices
      • Working with pharmacies, DME, Home Health and other post-acute care providers to obtain options for providing services and associated costs and reporting to Management
      • Processing vouchers, reviewing invoices for legitimacy and working with vendors and EH accounts payable department in rectifying discrepancies
      • Attending Finance Department, accounts payable meetings
      • Assisting Director in activating and processing new contracts and in monitoring grant funding
    • Working closely with case managers and social workers, completes care coordination tasks for assigned complicated cases, including securing placement, arranging transportation, facilitating access to medication and other discharge related tasks.
    • Documents interventions in EMR.
    • Develops and maintains a comprehensive guidebook to include referral processes and resource lists through:
      • Assisting CM leadership in identifying community resources for patients
      • Serving as liaison with the community in identifying new post-acute care providers and community resources for patients
      • Taking the lead in locating outpatient Hemodialysis units for new patients and arranging post-acute care in a timely manner
      • Keeping interdisciplinary team updated on community resources
      • Keeping resource lists up to date
      • Participating in vendor meetings to develop strategies to improve patient referrals to community
    • Participates in the education and training of medical providers, nursing staff, discharge planning coordinators and other case management team members regarding discharge planning needs and processes.
    • Participates in the orientation of new department employees and contract employees to familiarize them with complex discharge planning processes .
    • Assists new employees and liaisons with community partners to obtain access to the EMR system, ID badges if applicable and accessing other systems required in order to streamline discharges and prevent delays.
    • Assist department director in researching invoices for department approval.
    • Communicates directly with managers when issues or needs for process changes are identified.
    • Maintains patient confidentiality and follows HIPAA practices.
    • Performs other duties as assigned.