Primary Focus: To provide patient-centered care through utilization management, case management, and discharge planning for patients in acute care, extended care, ambulatory care, and emergency department settings.
Key Responsibilities:
Patient Assessment and Planning:
Collaborate with healthcare teams to assess patients' care needs, focusing on discharge and transition planning.
Preventative Care:
Identify risks and intervene to prevent unnecessary hospital admissions or readmissions.
Discharge Facilitation:
Coordinate and execute timely patient transitions/discharges, ensuring continuity of care.
Team Collaboration:
Serve as a liaison between patients, families, and multidisciplinary healthcare teams.
Documentation:
Maintain accurate and timely documentation in alignment with care standards and regulatory requirements.
Core Competencies:
Strong understanding of utilization review processes to optimize care efficiency.
Expertise in case management strategies, including resource allocation and patient advocacy.
Proficiency in navigating complex discharge planning scenarios to ensure safe patient transitions.
Excellent communication skills to work effectively within healthcare teams and with patients/families.