Discharge Planning In collaboration with team, contributes to defining the need for further resources or services.
Is able to communicate data to the treatment team in a clear and concise manner.
Participates in team meetings and huddles as needed.
Demonstrates understanding of the impact of ethnic, cultural, socioeconomic, gender and lifestyle issues.
Demonstrate knowledge and understanding of concrete services and discharge planning needs for adolescence, adults and geriatric population.
Coordinates with treatment team in facilitating an optimal discharge plan for Patients demonstrating knowledge of general and age specific resources including availability, eligibility, cost factors and types of service.
Assists team to identify appropriate resources that meet patient/family level of care needs that are within patient’s financial, transportation or other constraints
Takes an active role in providing continued communication and information between the treatment team and community agencies and professionals (unless delegated to another team member).
Keeps current knowledge of community resources as demonstrated by providing accurate information on the availability of resources to staff, patients, and families including what is not available due to restrictions, costs suitability or lack of resource
Demonstrates patient and family involvement in the discharge planning process via written documentation
Completes appropriate documentation in a timely fashion. Completes documentation of, releases, assessment and other appropriate forms within prescribed time frames.
Documents significant patient and family encounters as well as contacts with other professionals and community agencies.
Completes Social Services record forms promptly and accurately.
Documents the discharge plan in the EMR.
In collaboration with treatment team, performs utilization review functions and serves as the primary liaison with ERO’s.
Performs all concurrent review procedures: pre-admission, admission, continued stay and discharge utilizing established hospital criteria as well as criteria set by ERO.
Manages the process of expedited reviews and appeals according to department policy and external requirements.
Manages the process of denial of benefits according to regulatory agency requirements and insures notification of both internal and external customers.
Maintains accurate and up to date written and computerized records of all cases and all cases in review.
Regularly provides feedback to clinical team on benefits and utilization issues related to case.
Maintains computer skills necessary to complete all work.
Education: Bachelors Degree required. MSW or Master Degree in Counseling preferred.
Training and Experience: Training and clinical experience in behavioral health required and necessary case management experience.
Mental Demands – Able to tolerate the stress of multiple demands of working in a fast-paced environment and dealing with multi-disciplinary staff and difficult patient population.