Inpatient Care Navigator/Discharge Planner RN or SW, Per Diem Day Shift, Care Navigation

Adventist HealthCare•Silver Spring, MD

45d•Onsite

About The Position

Adventist Health seeks to hire an experienced Inpatient Care Navigator/Discharge Planner RN or SW for our Care Navigation department who will embrace our mission to extend God's care through the ministry of physical, mental, and spiritual healing. As a Care Navigator/Discharge Planner RN or SW, you will: Complete comprehensive psycho-social assessment and review of clinical needs of patients with focus on patient's requirements as they transition to the next level of care Collaborate with physicians, nurses, social workers and other disciplines involved with care of the patient to foster a coordinated approach to discharge planning Identify and navigate patient testing and treatment to reduce barriers to patient discharge and preventing delays in patient care; communicates barriers to leadership for resolution and trending Work with high-risk population admitted to the hospital, navigating the discharge plan of care and follow up. Continues to reach out to the High-Risk Population for support and triage of patient needs Serve as liaison in planning care between patients, caregivers and multi-disciplinary health care providers Assist patients in understanding diagnosis, treatment options and resources available internal and external to the organization Communicate with Utilization Review staff on any denials, issues or barriers to discharge Identify services and resources available in the community and assists with patient connection to these services Participate in Interdisciplinary Rounds and other patient care conferences Document assessments and interventions according to departmental standards Communicate with Utilization Review staff on any denials, issues or barriers to discharge Participate in process improvement activities

Requirements

Registered Nurse (RN) - Graduate of an accredited school of nursing with a minimum of an associate of science degree required, bachelor's degree preferred
RN-minimum of 1-3 years clinical experience required
Licensed as Registered Nurse with Maryland Board of Nursing
Social Worker (SW) - Bachelor of Social Work (BSW) or Master of Social Work (MSW)
SW-minimum of 3 years of experience in diverse clinical setting is required
SW-LBSW, LMSW, LCSW
Active American Heart Association Basic Life Support (BLS) certification required

Nice To Haves

Preferably prior case management or discharge planning experience
Experience with Cerner EMR and All Scripts is preferred

Responsibilities

Complete comprehensive psycho-social assessment and review of clinical needs of patients with focus on patient's requirements as they transition to the next level of care
Collaborate with physicians, nurses, social workers and other disciplines involved with care of the patient to foster a coordinated approach to discharge planning
Identify and navigate patient testing and treatment to reduce barriers to patient discharge and preventing delays in patient care; communicates barriers to leadership for resolution and trending
Work with high-risk population admitted to the hospital, navigating the discharge plan of care and follow up. Continues to reach out to the High-Risk Population for support and triage of patient needs
Serve as liaison in planning care between patients, caregivers and multi-disciplinary health care providers
Assist patients in understanding diagnosis, treatment options and resources available internal and external to the organization
Communicate with Utilization Review staff on any denials, issues or barriers to discharge
Identify services and resources available in the community and assists with patient connection to these services
Participate in Interdisciplinary Rounds and other patient care conferences
Document assessments and interventions according to departmental standards
Communicate with Utilization Review staff on any denials, issues or barriers to discharge
Participate in process improvement activities