POSITION SUMMARY Responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination. Has overall responsibility to assess the patient for transition needs including identifying and assessing patient at risk for readmission. Conducts complex psycho-social assessment and intervention to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including: Transition Management promoting appropriate length of stay; readmission prevention and patient satisfaction; Care Coordination by demonstrating throughput efficiency while assuring care of sequenced and provided at the appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy; Education provided to physicians, patient, families and caregivers; Updates Case Managers/Discharge Planners/ Social Workers on variance to post-discharge plans; Maintains an updates list of providers for postdischarge care; Provides educational programs for Case Management Department on community resources use in discharge planning; Provides reports to DCM and hospital leadership as requested; Team Leader for discharge planning unit, providing guidance and monitoring. Completes established competencies for the position within designated introductory period. Other related duties as assigned
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Job Type
Full-time
Career Level
Mid Level