复杂出院计划员
Complex Discharge Planner
职位职责：根据需求评估，为高风险会员制定、评估和协调复杂的出院计划。协助确保从急性护理环境顺利过渡到下一阶段的护理，并对会员及其家庭/照护者进行出院计划教育，以确保适当的高质量过渡护理。
关键信息：这是一个全远程职位，需要有效的Compact RN执照。有电话环境中的病例管理及/或出院计划经验者优先。
- 根据需求评估确定的会员护理等级，制定复杂的出院计划，以确保适当的护理等级
- 与提供者、社区机构和其他利用审查人员互动，协调并确保会员的安全、有效且临床适当的过渡计划
- 协助管理会员的出院计划，确保在不同护理级别和设施之间及时、顺利地出院
- 根据利用管理政策和指南，收集、记录并维护所有会员的出院计划到健康管理系统中的医疗记录
- 协助向会员及其家庭提供出院计划和利用流程的教育，以确保会员获得适当高质量的护理
- 向领导层提供反馈，以改进会员的出院计划流程，确保高质量的过渡护理
- 协调并协助完成与出院计划相关的预先授权工作
- 在需要时协助同时审查团队
- 执行其他指派的任务
- 遵守所有政策和标准
教育/经验：要求毕业于认证的护理学校或获得护理学士学位，并具有2-4年相关经验。需要2年以上急症护理经验。
- 优先具备出院计划能力的临床知识。
- 优先了解Medicare和Medicaid法规。
- 优先了解利用管理流程。
执照/认证：
· RN - 注册护士 - 州执照和/或Compact州执照
薪资范围：每小时27.02至48.55美元
在Centene，我们帮助人们获得他们需要的护理，以过上更健康的生活——你在这里的工作每天都会带来真正的影响力。你将面对直接支持个人和家庭的重要挑战。
查看英文原文
Position Purpose: Develops, assesses, and coordinates complex discharge plans for high-risk members based upon needs assessment. Assists with the facilitation of a smooth transition from the acute care setting to the next level of care and educates members and their families/caregivers on discharge plan to ensure appropriate high-quality transitional care.
Key Details: This is a fully remote opportunity that requires an active Compact RN License. Prior Case Management and/or Discharge Planning experience working in a telephonic environment highly preferred.
- Develops complex discharge plans based on level of care of members needs determined by needs assessment to ensure appropriate level of care
- Interacts with providers, community agencies, and other utilization review staff to coordinate and ensure a safe, effective, and clinically appropriate transition plan for the member
- Assists with managing member’s discharge plans to ensure a timely and smooth discharge between levels of care and facilities
- Collects, documents, and maintains all discharge plans taken on member medical records in health management systems according to utilization management policies and guidelines
- Assists with providing education to members and their families on discharge plan and utilization processes to ensure high quality appropriate care to members, as applicable
- Provides feedback to leadership on opportunities to improve the discharge planning process for members to ensure high-quality transitional care
- Coordinates and assists with completion of prior authorizations as they related to discharge planning, as applicable
- Assists concurrent review team as needed
- Performs other duties as assigned
- Complies with all policies and standards
Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience. 2+ years of acute care experience required.
- Clinical knowledge of discharge planning competencies preferred.
- Knowledge of Medicare and Medicaid regulations preferred.
- Knowledge of utilization management processes preferred.
License/Certification:
· RN - Registered Nurse - State Licensure and/or Compact State Licensure
Pay Range: $27.02 - $48.55 per hour
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Originally posted on Himalayas