The following statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.
The Post-Discharge Care Coordinator is responsible coordinating the care of medical, behavioral health, and substance use disorder patients as they transition out of their inpatient stay at the Psychiatric Institute of Washington. Responsibilities include coordinating patient care to improve quality of care through the efficient use of resources and thereby enhancing quality outcomes. You will act as an advocate for an individual’s healthcare needs, and coordinate care to minimize the fragmentation of health care delivery systems. This position is committed to the constant pursuit of excellence in improving the health status of the community.
The Ideal candidate is a Registered Nurse (RN) who is capable of providing various services, to include but not limited to:
Thoroughly review the patient’s chart on day of discharge.
- Go over any abnormal lab findings and make the necessary treatment or follow up recommendations. Access the need for primary care, mental health services, or addiction services and make the necessary referrals, whether it be to one of our providers, the patient’s current provider, or linking them to one of our collaborating organizations.
- Ensure that all relevant discharge information is recorded accurately, processed on time and is communicated to the multi-disciplinary team.
The Post-Discharge Care Coordinator assists the patient by providing support and helping them navigate and confirm the care and treatment needed to prevent hospital readmission. The candidate will provide a valuable service to patients, their families, and the care team by working collaboratively with the patient and a medical assistant or counselor upon discharge.
Scope of Services
- Provide PIW Post Discharge Clinical Assessments via Tele-visits
- Provide PIW Clinical Oversight for Support Staff, Call Center and Medical Assts.
- Review chart medical history, assess health status, diagnose any potential issues, and work with physicians and other health professionals to provide in-patient care.
- Document all encounters in MHDG’s electronic health record and in the hospital’s ordering system (HCS) with notes. All orders must be addressed within 24hrs.
- RN’s must follow strict guidelines and protocols to protect themselves against illness and disease, as they may work in close contact with people who may have infectious diseases.
- A bachelor’s of science in nursing
- An associate degree from a community or junior college.
- Diploma programs obtained through hospital programs
- Certifications or proof of passing National Council Licensure Examination (NCLEX-RN)
Hours: Part-time position Monday-Friday, or elected days during the week. Projected hours 9:00am – 2:00pm, could adjust pending patient census.
Required Certifications, Licenses, Registrations: HIPAA, CPR
Supervisory Responsibilities: This position has no supervisory responsibilities.
Supervision received from: Director, HR Services/Lead Provider
Specialized Knowledge or Skill: Keyboard
Mathematical Skills: Basic math skills of addition, subtractions, multiplication and division are required.
Reasoning Ability: Job tasks are predictable and usually require the selection from standard operating procedures. Requires analysis to determine appropriate procedure and monitoring results.
Language Skills: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization. Writing is required to produce reports, business correspondence and procedure manuals.
Problem Solving: Difficult problems are encountered and it may be hard to identify all of the related issues. Solutions require research, analyzing multiple factors, conflicting information, etc.
Specialized Skills: Include but are not limited to the following
- Intermediate Level Computer Skills:
- Intermediate level word processing skills.
- Intermediate level spreadsheet skills.
- Intermediate level software application navigation skills.
- Practice Management Software
- Electronic Health Records Software
- Microsoft Office
Medical Home Development Group
Why Work Here?We are a privately-owned physician group and management consulting company specifically trained to deliver a wide range of healthcare services and expertise, including chronic conditions, behavioral health, and addiction treatment. And we are playing a leading role in the fight against the opioid epidemic.Become part of our patient-centered practice! If you're dedicated to high-quality care for every individual, we want to hear from you.
Medical Home Development Group is a patient centered medical practice, providing quality service and passionate healthcare