Discharge Planner

CFG HEALTH SYSTEM LLC•Town of Goshen, NY

3d•$55 - $55•Onsite

About The Position

The Discharge Planner is responsible for coordinating and facilitating safe, timely, and effective discharge planning for patients. This position works collaboratively with medical, behavioral health, nursing, social services, community providers, patients, families, and other stakeholders to develop individualized discharge plans that address ongoing healthcare, behavioral health, housing, medication, and community support needs. The Discharge Planner ensures continuity of care by coordinating referrals, appointments, medications, transportation, community resources, and other services necessary to support successful transition from the facility to the next level of care.

Requirements

A bachelor’s degree is required in criminal justice, Social Work, Psychology, mental health, human services, or a related field.
CASAC license
Knowledge of medication-assisted treatment practices is required.
Strong interpersonal, organizational, and communication skills.
Ability to work collaboratively with correctional staff, community partners, and treatment providers.

Nice To Haves

Master's preferred
Experience working with individuals involved in the criminal justice system preferred.

Responsibilities

Assess patients' discharge planning needs and identify potential barriers to successful transition of care.
Develop individualized discharge plans in collaboration with patients, healthcare providers, and interdisciplinary team members.
Coordinate discharge planning activities from admission through discharge to ensure continuity of care.
Coordinate referrals to medical, behavioral health, substance use, social service, housing, and community-based programs as appropriate.
Schedule follow-up medical, psychiatric, counseling, specialty, and primary care appointments.
Coordinate medication needs and ensure appropriate prescriptions, medication information, and continuity of treatment are addressed prior to discharge.
Communicate with hospitals, rehabilitation facilities, treatment programs, community providers, residential programs, and other outside agencies.
Obtain and provide appropriate clinical and discharge-related information to receiving providers while maintaining patient confidentiality.
Assist patients in identifying and accessing community resources, including healthcare, behavioral health, substance use treatment, housing, transportation, financial assistance, and social services.
Identify patients requiring additional support or specialized services following discharge and make appropriate referrals.
Coordinate transportation arrangements when necessary to facilitate safe discharge.
Monitor pending referrals, appointments, medical records, and other discharge requirements to ensure completion prior to release.
Participate in interdisciplinary treatment team meetings and communicate discharge planning updates and barriers.
Maintain accurate and timely documentation of discharge planning activities in the electronic medical record.
Follow applicable federal, state, and facility regulations regarding confidentiality, patient rights, and release of information.
Obtain appropriate releases of information when required.
Educate patients regarding their discharge plans, follow-up appointments, medications, treatment recommendations, and available community resources.
Advocate for patients and assist in resolving barriers that may interfere with successful continuity of care.
Collaborate with nursing, medical, behavioral health, case management, social work, and administrative staff to coordinate services.
Follow up on patients' discharge arrangements as appropriate and communicate changes or concerns to the appropriate clinical team.
Maintain current knowledge of available community resources and healthcare providers.
Assist with identifying gaps in community services and developing alternative plans when preferred services are unavailable.
Respond to urgent discharge planning needs and assist with developing safe alternatives when discharge plans change unexpectedly.
Perform other duties and responsibilities as assigned.