Complex Discharge Planner
Core
Develops, assesses, and coordinates complex discharge plans for high-risk members to ensure a smooth transition from acute care to the next level of care.
Role type
Senior Utilization Management Nurse (Discharge Planning)
Builds
Transitional care pathways for Medicaid and Market Place members
Domain
Healthcare / Utilization Management
Required skills
Acute care nursing experience, Discharge planning, Needs assessment, Care coordination, Prior authorization management, Health management systems documentation
Preferred skills
LTAC, Inpatient Rehab, or Skilled Nursing Facility experience, Medicare/Medicaid regulations knowledge, Utilization management processes knowledge
Technologies
Health management systems
Responsibilities
Develop complex discharge plans based on member needs, Interact with providers and community agencies to coordinate safe transitions, Manage member discharge plans for timely facility transfers, Document discharge plans in health management systems, Educate members and families on discharge processes, Provide feedback to leadership on process improvements, Coordinate prior authorizations related to discharge planning
Seniority
Mid-level, hands-on IC