Discharge Coordinator

Current Career•Prescott, AZ

3d•Hybrid

About The Position

The Discharge Coordinator is responsible for coordinating and facilitating all aspects of the discharge planning process for patients admitted to Polara’s inpatient facility. The Discharge Coordinator is a critical member of the multidisciplinary team and plays a vital role in ensuring safe, timely, and effective transitions of adult psychiatric patients from inpatient care to appropriate aftercare settings. This position involves comprehensive care coordination, planning, and collaboration to reduce readmission risk and support long-term recovery. The Discharge Coordinator role ensures that patients transition safely and effectively from inpatient care to the appropriate level of community-based care, support services, or home settings. This role works closely with other members of the Social Work team and the patient’s care team to coordinate individualized discharge plans to meet patient’s needs. The Coordinator collaborates with the multidisciplinary team, patients, families, internal programs and external agencies to develop comprehensive discharge plans that support continuity of care, stability, and recovery.

Requirements

21 years of age or older; or minimum 18 years old and licensed or certified under A.R.S. Title 32 and providing services within the personnel member’s scope of practice; or minimum 18 years old for select administrative positions
Must be able to provide or obtain an AZDPS Level One Fingerprint Clearance Card
Must possess and maintain a valid Driver License, current automobile insurance, and a driving record that meets the guidelines and requirements of the organization
Bachelor’s degree in a behavioral health field or minimum 2 years of experience working with adults in a behavioral health setting, or a combination of education and experience
Understanding of adult psychiatric disorders, co-occurring conditions, and mental health recovery models
Knowledge of local and regional community mental health resources, including housing, employment, and outpatient services
Excellent verbal and written communication skills
Organizational and time management skills; ability to prioritize multiple tasks
Compassionate and professional demeanor; ability to work with diverse adult populations, including individuals experiencing homelessness, substance use, or severe mental illness

Nice To Haves

Prior experience in discharge planning, case management, or care coordination preferred

Responsibilities

Initiate discharge planning upon admission for adult patients with acute psychiatric conditions.
Assess psychosocial, medical, housing, and support service needs to create individualized discharge plans.
Collaborate with psychiatrists, nurses, social workers, and other healthcare team members to assess discharge needs upon admission and throughout the patient's stay.
Coordinate referrals to outpatient behavioral health providers, intensive outpatient programs (IOPs), substance use treatment, housing services, vocational rehab, and other community resources.
Schedule follow-up appointments with psychiatrists, primary care physicians, therapists, and case managers.
Communicate with external agencies (e.g., community mental health centers, shelters, group homes, halfway houses) to ensure smooth transitions.
Collaborate with insurance companies or utilization review staff to obtain authorizations for post-discharge services.
Conduct family and support system meetings to prepare for discharge and educate support persons when appropriate.
Document all discharge planning activities in the electronic health record (EHR) in compliance with facility and regulatory standards.
Participate in daily treatment team meetings to communicate discharge progress and coordinate care plans.
Develop individualized discharge plans that consider the patient’s mental health status, housing, medication needs, outpatient services, and social support systems.
Facilitate family meetings or care planning conferences to support discharge goals.
Ensure patients and families understand discharge instructions and aftercare plans, including follow up appointments, warning signs of relapse, and crisis resources.
Maintain current knowledge of community resources, psychiatric treatment programs, and housing options.
Support efforts to reduce readmissions and improve patient outcomes through effective transition planning.