Discharge Review Specialist

Reports to the Manager or Director of Case Management. Provides coordinated care support to facilitate and expedite patient care services. Participates in daily rounds and collaborates with the clinical healthcare team across the patient care continuum to include preadmission and post hospital discharge. As a member of that team shares responsibility for the implementation of the discharge plan; ensures efficient and effective delivery of patient care services through the appropriate utilization of healthcare resources.

Collaborates with SNF committee team and care team members to evaluate post-acute discharge planning needs. Reviews the initial patient discharge plan and reviews with patient family members and other members of the interdisciplinary team. Reassesses the discharge as needed.

Partners with medical staff and other members of the healthcare team in collaboration with the patient/family to facilitate the plan of care for a defined patient population across the continuum of care. Identifies a high-risk patient population within the caseload for care management assessment screening and targets interventions in conjunction with the healthcare team within one business day of patient admission

Coordinates the length of stay with the physician care team and patient. Ensures team is informed of insurance qualifiers that may affect the discharge plan. Discuss approaching discharge readiness of patients. Identify and assess readmitted patients and complex patients in collaboration with members of the healthcare team to coordinate discharge.

Communicates the discharge plan recommendations to all members of the care team.

Acts as a change agent by identifying opportunities to improve patient flow and reduce service delays through problem resolution and follow-up.

Demonstrates a fundamental grounding in nursing theory and practice with a clinical background within a defined content area. Remains current on the latest concepts techniques and methods relative to his/her service.

Demonstrates knowledge of federal and state rules and regulations.

Reviews and acts as a change agent by identifying opportunities to improve patient flow and identifies and reduces service delays through problem resolution and follow-up. Identifies and tracks service and discharge patient delays.

Participates in departmental and/or interdepartmental quality improvement activities as requested: i.e. quality teams weekly long LOS reviews interdisciplinary rounds readmission reviews. Participates in Orienting of New staff as requested.

Participates in ongoing education-related professional activities and affiliations to maintain an advanced level of knowledge of patient care services third party payer and managed care requirements and case management.

BASIC KNOWLEDGE:

Graduate of a School of Nursing with current license to practice as a Registered Nurse in the State of Rhode Island.

Bachelor�s Degree preferred; years of experience will be considered.

Certification in Case Management by a nationally organization preferred or to be obtained within 1 year of hire.

BLS Certification preferred.

EXPERIENCE:

Three years of clinical experience with recent experience in case management community case management patient navigation or discharge planning is strongly preferred.

Three years of acute care case management experience required.

Strong analytical and interpersonal skills are required to provide guidance to and communicate daily with healthcare professionals patients and families.

Must exhibit a collaborative approach and method of communication to interact successfully on as daily basis with a wide and diverse population of both health care providers insurers patients and their families.

Demonstrates knowledge and skills necessary to provide care to patients throughout the life span with consideration of aging processes human development stages and cultural patterns in each step of the care process.

Must be proficient in the use of Microsoft Office software including email and Outlook calendar and have basic keyboarding skills.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

General hospital environment with occasional stressful conditions associated with patient care. Risk of exposure to blood borne pathogens and disease is minimized and controlled by adherence to Hospital Infection Control policy and procedures.

Must be able to make hospital rounds through various patient care areas either by walking or through some other mobile means. Visual acuity and finger dexterity is needed to review and carry medical records navigate through automated system screens and type on a typical computer terminal keyboard. Lifting of up to 10 lbs. may be necessary to transport items from one care unit to the next.

INDEPENDENT ACTION:

Responds to individual patient-care situations demonstrating knowledge and skills acquired through education certification and work experience.

SUPERVISORY RESPONSIBILITY:

None.