| Location | Bay City, MI |
Department: Case Management
Shift: Days
Daily Work Times: 7:00 am - 7:30 pm
Scheduled Biweekly Hours: 80
Position Summary:
Accountable for proactive coordination and timely transition of assigned patients to the most appropriate level of care along the continuum. Impacts key results such as achieving top decile performance in length of stay, cost efficient resource utilization, preventing readmissions and unnecessary emergency room visits. Works collaboratively with physicians, nursing, members of the multidisciplinary team (such as Home Care and PCP offices), as well as other resources internal and external to the organization.
Essential Functions and Responsibilities as Assigned:
Performs care coordination assessments for initial assessment of patients with 24 hrs. of admission. assessments for readmission and transition planning.
Works collaboratively with the social worker and other disciplines to ensure a safe, appropriate, and timely transition to the next level of care, taking into consideration the patient's available resources.
Assesses patient/family needs to reduce barriers and formulate discharge plans (e.g., LOS barriers to D/C).
Required
Preferred:
Additional Information