- Initiates the discharge planning process, works with patient, family, responsible party and/or conservator.
- Collaborates and rounds with Case Managers to discuss discharge plan. Updates regularly on discharge progress
- Works with outside facilities, vendors and providers while following the guidelines set by the insurer, Medicare and Med-iCal
- Coordinates transfer for both higher level of care, and discharge to a lower level of care
- Attends multidisciplinary rounding
- Initiate referrals and arranges post-discharge services
- DME, SNF, HH including: physical therapy, safety evaluation, wound care, dialysis, and IV infusion
- Completes and documents Patient Choice Form per CMS regulation on all Home Health and SNF placements for all Medicare products
- Supply family with any additional requested resources i.e. Caregivers, Board and Care, or Assisted Living (ALF)
- Assists with discharge transportation
- Ensures that the patient, family, responsible party and/or conservator are aware of and in agreement with the DCP
- Collaborates to obtain appropriate authorization from managed health care plans for discharge needs
- Maintains Medi-Cal Administrative Placement Lists for submissions to Medi-Cal
- Understanding of SNF placements and level of care through understanding of Medi-Cal administrative daily process
- Monitors and assists/delivers the Medicare IMM’s (Important Message from Medicare) and the Patient Choice Form.
- Maintain ongoing and consistent communication with nursing, physician, patient, patient representative and case management regarding plan and updates.
- Document all interactions in Paragon
- Escalate any barriers or issues to the Leadership Team as they arise.
- Performs other duties as assigned
- High school Diploma or equivalent
- Bachelor’s Degree preferred
- College courses in Business Administration and/or Healthcare Administration preferred.
- Ability to communicate effectively verbally and in writing.
- Must be able to work in a union environment.
- N/A
- Current Los Angeles County Fire Card required (within 30 days of employment).
- Assault Response Competency (ARC) required (within 30 days of hire).
Shift Hours: Varied
Weekly Hours: 40
Type/Status: Full-Time
FTE: 1.0
Professional Field
Nursing
Other Behavioral, Mental, or Healthcare FieldPatient Focus
Diagnoses
Avoidant Personality Disorder
Therapeutic Approach
Methodologies
ECT
Modalities
Families
Practice Specifics
Populations
Law Enforcement/Fire/First Responders
Aviation/Transportation
Racial Justice Allied
School
Settings
In-patient Non-Psychiatric
In-patient Psychiatric
Milieu
Nursing Home
Research Facilities/Labs/Clinical Trials
Home Health/In-home




