Discharge Planner - Home Care coordinates the movement of patients between a hospital or skilled nursing facility and a home care or hospice arrangement. Reviews the patient's case and determines the best choice in services and facility to meet the medical and social needs of the patient. Being a Discharge Planner - Home Care ensures a safe transfer to a setting that meets the patient's needs and coordinates necessary services and staff required to complete the transfer. May require a bachelor's degree. Additionally, Discharge Planner - Home Care typically reports to a supervisor or manager. The Discharge Planner - Home Care gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Discharge Planner - Home Care typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
The Care Manager- Discharge Planner is a core member of the hospital care team and leads discharge planning through full partnerships with caregivers, internal and external providers/customers, and patients and their families and communities. This role contributes to the transformation of the health care system into one that meets the demands for safety, quality, patient-centered and affordable care. This position is responsible and accountable for coordinating the interdisciplinary process that occurs throughout the continuum of care to ensure care coordination, communication and collaboration with patients, families, providers, ancillary services and community partners in order to achieve goals and maximize positive patient outcomes based upon individual assessments of patients' needs. Discharge planning will begin at the time of (and prior) admission, and reassessed during hospitalization. Concurrently intervenes to enhance patient quality outcomes and serves as a patient advocate.
Discharge Planning
Supports the Care Management/Utilization Review Roles and Functions
Collaborate with insurance companies, Social work, and other hospital departments when patient care needs exceed health benefit coverage limitations to negotiate and provide for patient care needs.
Patients will be assessed to determine appropriateness of admission, use of observation status, continued hospitalization. and placed in appropriate level of care. Maintain knowledge of Medicare-Medicaid guidelines and coding specifics. Communicate with physicians to ensure compliance with Guidelines.
Communicate with third party payers and insurance companies. Provide clinical information, including patient status, plan of care and discharge disposition as requested.
Utilizes MCG, Intensity of Service, and Severity of Illness criteria to determine eligibility for acute care and observation services.
Utilization Review: Perform both concurrent and retrospective monitoring and analysis of variations in the processes of care. Identify and recommend opportunities for improvement as appropriate. Collaborate with nursing/MD, Quality Improvement department.
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