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You will be updated with latest job alerts via emailQUALIFICATIONS:
1. Bachelors Degree preferred and health care experience preferably in extended care facilities and community agencies.
2. Minimum 2years experience in hospital discharge planning long term care communityhealth or utilization review.
3. Bilingual(English/Spanish) preferred.
SKILLS/ ABILITIES/ COMPETENCIES REQUIRED:
1. Interpersonalskills to interact effectively with various levels of staff patients familiesand community organizations. Must beable to participate effectively in an interdisciplinary team setting. Must be flexible.
2. Extensiveknowledge of regulations community organization state and federal systemsmedical terminology and levels of health care.
3. Must be ableto manage a variable workload with the ability to constantly changepriorities. Requires ability to workindependently.
4. Requiresbasic typing and/or computer data entry skills experience with personal computerand software desirable.
5. Must be veryflexible in a constantly changing environment.
WORKING CONDITIONS:
Works in a busy and at times stressful hospital/officeenvironment. Must be able to work wellindependently and in a multidisciplinary group. Must be flexible.
Brigham and Womens Hospital is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race sex color religion national origin sexual orientation protected veteran status or on the basis of disability.
GENERALSUMMARY/OVERVIEW:
As a member of the Care Coordination Team the ResourceSpecialist coordinates patient resources throughout the continuum under thedirection of the Care Coordination Managers thereby facilitating theachievement of optimal resource management and customer satisfaction. Acts as a consultant to the teams hospitalcommunity and ambulatory practices.Provides education and referral information regarding extended carefacilities placement process homecare and community resources as appropriateincluding levels of care long term care assessment forms and Medicare/Medicaidrules and regulations regarding placement.
Patient CareManagement:
1. Acts as aconsultant to the hospital community patients and families regarding theplacement process and community resources.
2. Participatesin family meetings and interdisciplinary team meetings as appropriate todevelop and execute the discharge plan.
3. Assessesreferred patients to determine if appropriate for homecare; determines ifagency care effectively meets the homecare needs of the referred patient.
4. Establisheshome care plan in conjunction with the Care Coordination Nurse and SocialWorker and documents the plan and progress in themedical record including assistance with obtaining medications needed atdischarge.
5. Coordinatesdemonstration/observation for homecare services when patient care involves newor unfamiliar procedures; arranges in conjunction with Care Coordination Nurseand Social Worker.
6. Coordinatesand expedites final transfer with staff patient family and facility.
7. Updates thestaff on new facilities and services and maintains a library of referencematerials.
ReferralManagement:
1. Referspatients and/or their families to other hospital and communityresources/services as appropriate.
2. Activelycommunicates consults and collaborates with a wide range of social agenciesclinics schools and courts.
3. Plans whenappropriate a continuation of previous utilization management services and/oragency for continuity of care.
4. Maintains astatistical data base on referrals admissions and homecare/community agencyresources and tracks discharge process utilized by the patient.
5. Interpretsinsurance coverage for homecare of referred patients and obtains approval forservices by payer or negotiates method of payment before discharge.
6. Coordinatesin conjunction with the Team long and short term placements to extended carefacilities eg. rehabs subacute etc.
7. Maintainscontact with appropriate facilities to advocate patient admissions..
Evaluation:
1. Monitorsquality of care in ECFs home/community agencies and reports findings to theCare Coordination Managers.
2. Maintainscurrent information on nonacute provider agencies including SNF subacuteacute rehab and chronic facilities including programs homecare andspecialties available. Acts as aresource to staff patients and families concerning this information.
3. Provides followupand ongoing assistance with assessing community and ECF services. Follows up and tracks utilization of referredpatients for evaluation purposes and provides feedback to the CCT.
4. Participatesin relevant planning meetings to provide input into practice and program needs.
PerformanceImprovement:
1. Participatesin the development and monitoring of performance standards for extended carefacilities and homecare/community agencies.Maintains documentation to support findings.
2. Maintainscontact with State regulatory agencies and nonacute care provider agencies tokeep current on the rules and regulations needed to facilitate dischargeplanning.
Required Experience:
Unclear Seniority
Full-Time