Discharge Planner

General Purpose

Utilize critical thinking skills and care coordination expertise to work collaboratively with residents, resident family/significant other, healthcare providers, insurers, community resources, and other involved parties to develop and implement a plan of care that provides extraordinary care for the patient while being sensitive to costs and resources.

Essential Duties


* Communicate regularly with residents and their families about Plans of Care, PT, OT, and other treatment protocols.


* Attend and participate in morning meetings/stand‑ups to facilitate communication with the team.


* Answer residents' questions about their care, treatment plans, illness progression, and other issues to ensure they feel safe and secure in our care.


* Monitor and adjust residents' statuses based on changing needs and conditions.


* Organize and prioritize daily work by assessing new, current, and discharging residents' needs in areas of responsibility.


* Complete documentation as required.


* Perform utilization review activities to provide residents with appropriate, timely, and cost‑effective care.


* Coordinate care with residents, care providers, facility financial services, and third‑party payers.


* Oversee all admissions and discharge activities.


* Coordinate referrals both to and from the facility.


* Relate positively, effectively, and appropriately with residents, families, staff, and professional colleagues.


* Ensure accurate charting and timely completion of necessary paperwork.


* Work independently and exercise sound judgment in interactions with physicians, providers, payers, residents, and families.


* Communicate effectively and promote cooperation and collaboration among residents/families/caretakers, physicians, nurses, and other ancillary partners.


* Demonstrate excellent time management skills to develop organized work processes in a high‑volume environment with rapidly changing priorities.


* Utilize intermediate computer skills.


* Maintain professional, respectful, and honest interactions with residents, families, staff, and partners.

Supervisory Requirements

This position has no supervisory responsibilities.

Qualification

Education and/or Experience


* Bachelor's Degree in Social Work, Human Services, Nursing, or related field preferred (non‑licensed candidates accepted).


* Prior experience in healthcare, case management, or social services strongly preferred.


* Knowledge of Medicare, Medi‑Cal, and Medicaid programs and benefits.


* Familiarity with PCC (PointClickCare) or other electronic medical record systems preferred.


* Certificate as a Certified Case Manager (CCM) a plus.


* Strong communication skills with the ability to read and comprehend policy and procedure manuals, and effectively present information to residents, families, and staff.


* Demonstrated ability to organize, prioritize, and m...