University of Southern California

Research university in Los Angeles, CA

Discharge Planning Coordinator - Multiple Teams

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Part-timeLos Angeles, CA, USA$28 - $47.75 /hrIn-person

About the Job

Requirements

High school diploma or equivalent.
Completion of an accredited vocational nursing program.
Two to three years of clinical experience.
Typing speed of 40–55 words per minute and experience with computer data entry.
Proficiency in the Microsoft Office Suite.
Good organizational skills.
Strong command of the English language.
Good customer service skills.
Ability to multitask and work effectively in a team environment.
Licensed Vocational Nurse license issued by the California Department of Consumer Affairs.
Fire Life Safety Training certification for Los Angeles City assignments; if not held upon hire, it must be obtained within 30 days and maintained through renewal before expiration.

Responsibilities

Partner with Continuum of Care team members, including case managers and social workers, to coordinate smooth transitions from the hospital to home or another level of care for patients and families.
Coordinate communication at discharge with Care Coordination team members and provide timely post-acute contact, reinforcing discharge instructions under the Transitional Care Coordinator's direction.
Review post-acute referrals through platforms such as Enso Care, electronic fax, and phone; review discharge instructions and summaries to understand the post-acute plan and follow-up barriers, and follow up on referrals.
Participate in post-discharge calls to patients using scripts and the Cipher Health communication algorithm under the Transitional Care Coordinator's direction.
Communicate with clinic physician staff and other post-acute providers about discharged patients with identified needs under the Transitional Care Coordinator's direction.
Follow established policies, procedures, and workflows for post-discharge calls.
Communicate discharge plans and their status to Continuum of Care team members, participate in triad huddles, and assist with assigning triad team work.
Contact post-acute care facilities to assess bed availability, submit referrals, and determine bed-hold days; use referral platforms, including fax and Enso Care, to facilitate referrals.
Coordinate assigned non-clinical discharge-planning needs, including durable medical equipment, homeless shelters, non-clinical letters, and transportation; report psychosocial needs, barriers, and challenges to the appropriate team member.
Communicate with Continuum of Care team members about discharge needs and priorities, relay orders to the appropriate case manager, coordinate daily triad assignments and tasks, and hand off unperformed tasks.
Participate in departmental meetings, staff meetings, daily huddles, triad huddles, and Continuum of Care team meetings.
Use resources such as Medicare.gov and patient-choice tablets to provide information about skilled nursing facilities and discharge-planning resources within 10 miles of the patient's home or as close as possible.
Document in the electronic medical record according to departmental standards.
Assist with transfers for lateral or acute services.
Arrange patient transportation using taxis, rideshare services, ambulances, and other options.
Maintain and update pamphlets, brochures, and other resources for post-acute services.
Participate in continuous-improvement activities, huddles, and process-improvement projects.
Follow departmental standards and the Triad Model of Discharge Planning and support transitions of care.
Develop and maintain positive working relationships with post-acute facilities and vendors to support timely discharge and transfer.
Apply clinical knowledge to InterQual discharge screens and assess clinical stability for transition to the next appropriate level of care.
Complete the clinical authorization process for discharge medications.
Float between assignments and Keck and Norris hospitals as required; provide on-call and weekend coverage, including rotation to address organizational discharge needs.
Support the Continuum of Care team's outcome metrics, key performance indicators, and departmental goals.
Represent the department professionally.
Perform other duties as requested or assigned by the Director.

Provides department support for the Continuum of Care Team to facilitate discharge planning and ensure appropriate throughput of patients. Works with Case Managers, Transitional Care Coordinator, and Social Workers to ensure discharge plans are communicated to patients and families during hospitalization and post discharge to ensure continuity and identify clinical barriers. Enables a positive patient experience through the discharge process and connection to resources as needed.

Essential Duties

Partners with members of the Continuum of Care team both case managers and social workers (RN Case Manager, SW Case Manager) in an effort to provide patients and family members a smooth, coordinated patient transition from hospital to home and/or the next level of care.
Partners with members of the Care Coordination team to ensure appropriate communication occurs at the point of discharge so that the patients’ transition is smooth. Provides timely post-acute contact and reinforces post discharge instructions as needed under the direction of the Transitional Care Coordinator.
Under the direction and supervision of Transitional Care Coordinator, utilizes multiple referral platforms such as Enso care, e-fax and phone calls etc. to review post-acute referrals. Also reviews discharge instructions and discharge summary to understand patients’ post-acute plan of care and barriers to follow-up. Provides timely follow-up on all referrals.
Under the direction and supervision of the Transitional Care Coordinator, participates in post discharge phone calls to patients. Uses scripts and follows the Cipher Health algorithm for communication with discharged patients.
Under the direction and supervision of the Transitional Care Coordinator, communicates frequently and directly with clinic physician staff and other post-acute providers as needed for discharged patients with identified needs.
Follows established policies and procedures and workflows regarding post discharge phone calls.
Communicates the discharge plan, status of plan to members of the Continuum of Careteam, including allied health care team members. Participates in triad huddles and in the provisioning of assignments of the triad team.
Contacts post-acute care facilities as directed by the Continuum of Careteam to assess bed availability, submission of referrals, bed-hold days. Utilizes multiple referral platforms such as faxing, Enso care etc. to facilitate referrals.
Coordinates all non-clinical aspects of the discharge planning process as assigned (i.e. durable medical equipment, homeless shelters, non-clinical letters, transportation) reporting any psychosocial needs, barriers or challenges to the appropriate Continuum of Careteam member.
Communicates frequently and directly with Continuum of Care team members regarding discharge process needs and priorities. Communicates orders received to the appropriate case manager, works with the Triad team for daily assignments and tasks needing to be completed. Hands off tasks and duties not performed.
Participates in departmental meetings, including but not limited to staff meetings, daily huddles, triad huddles, and Continuum of Care team meetings, etc.
Utilizes tools (i.e. Medicare.gov website, tablets for patient choice, etc.) as needed to provide patients with skilled nursing facilities and/or information on discharge planning resources within 10 miles or as close to the patient’s home as possible.
Documents appropriately following departmental standards in the electronic Medical Record.
Assists with transfer of patients for lateral and/or acute services.
Supports the Continuum of Careteam with arranging transportation using Taxi, Ride Share, ambulance etc.
Assists with maintaining and updating current resources (i.e. pamphlets and brochures) for services as needed for post acute care for use by care coordination team.
Participates and engages in continuous improvement activities, including huddles and process improvement projects.
Follow all departmental standard work and guidelines including the Triad Model of Discharge Planning. Support transitions of care.
Develops and maintains positive working relationships with outside post-acute facilities and vendors to promote timely discharge/transfer.
Thrives in a fast-paced, multi-faceted team environment, working well with the key stakeholders, meeting tight deadlines, and multitasking a variety of assignments.
Strives to support and contribute to the success of the Continuum of Care team’s outcome metrics, key performance indicators and /or departmental goals and objectives.
Represents the department in a positive and professional manner.
Floating between assignments and between Keck and Norris hospitals is required for management of department needs. On-call, weekend coverage and rotation to manage the discharge needs of the patients within the organization is expected.
Supports the clinical process for transfer from one level of care to another as medically indicated by the patient’s needs. Able to apply clinical knowledge to reference InterQual Discharge Screens and clinical stability for discharge/transition to the next appropriate level of care.
Completes clinical authorization process for the discharge medications.
Performs other duties as requested/assigned by Director.

Required Qualifications:

Req High school or equivalent
Req Specialized/technical training Nursing Completion of an accredited vocational nursing program.

Req 2 years 2-3 years’ clinical experience.

Req Typing 40-55 WPM. Experience with computer data entry.
Req Proficient in Microsoft Office Suite.
Req Good organizational skills.
Req Strong command of the English language.
Req Good customer service skills.
Req Ability to multitask and work effectively in a team environment.

Preferred Qualifications:

Required Licenses/Certifications:

Req Licensed Vocational Nurse - LVN (CA DCA)
Req Fire Life Safety Training (LA City) If no card upon hire, one must be obtained within 30 days of hire and maintained by renewal before expiration date. (Required within LA City only)

The hourly rate range for this position is $28.00 – $47.75. When extending an offer of employment, the University of Southern California considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, key skills, internal peer equity, federal, state, and local laws, contractual stipulations, grant funding, as well as external market and organizational considerations.

USC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, or any other characteristic protected by law or USC policy. USC observes affirmative action obligations consistent with state and federal law. USC will consider for employment all qualified applicants with criminal records in a manner consistent with applicable laws and regulations, including the Los Angeles County Fair Chance Ordinance for employers and the Fair Chance Initiative for Hiring Ordinance, and with due consideration for patient and student safety. Please refer to theBackground Screening Policy Appendix Dfor specific employment screen implications for the position for which you are applying.

We provide reasonable accommodations to applicants and employees with disabilities. Applicants with questions about access or requiring a reasonable accommodation for any part of the application or hiring process should contact USC Human Resources by phone at (213) 821-8100, or by email at [email protected]. Inquiries will be treated as confidential to the extent permitted by law.

If you are a current USC employee, please apply to this USC job posting in Workday by copying and pasting this link into your browser:

https://wd5.myworkday.com/usc/d/inst/1$9925/9925$147130.htmld

About the Company

University of Southern California

Research university in Los Angeles, CA

The University of Southern California is a private research university with academic programs across the arts, sciences, business, engineering, law, health, and other professional fields.

Company size: Not listed
Company stage: Not listed
Total funding: Not listed
Headquarters: Not listed
Founded: Not listed

Recently Posted Jobs

Explore more opportunities at University of Southern California

See more jobs