Description
Primary City/State:
Mesa, ArizonaDepartment Name:
Case Mgmt-HospWork Shift:
DayJob Category:
Clinical CareFind your path in health care. We want to change the lives of those in our care – and the people who choose to take on this challenge. If you're ready to change lives, we want to hear from you.
As a Transitional Care Associate, you will facilitate the safe and timely transition from acute care to alternative levels of care such as skilled nursing facility, long-term acute care, inpatient rehabilitation, home infusion therapy, hospice and/or home care program. You will also facilitate discharge plan for the transition of care and services into the designated setting or service. Additional responsibilities include providing on-site or telephonic discharge arrangements to post-acute and community services. You should be willing to work collaboratively with care coordination team members to identify any barriers to a safe discharge, and works with patient/family to provide clear communication regarding discharge plan.
Schedule: 4 Ten hour shifts, 7am-5:30pm, with rotating weekend. This position offers a weekend schedule which is eligible for a flat rate $3/hour weekend shift differential.
Located on an 80-acre campus in Mesa, Arizona, Banner Desert Medical Center is one of Arizona's largest and most comprehensive hospitals and was recognized by U.S. News and World Report as one of Phoenix's Best Hospitals. We provide an abundance of exceptional opportunities with more than 700 licensed beds, including over 100 dedicated to children and 76 dedicated to our NICU. Areas of excellence include high-risk pregnancy and neonatal care, obstetrics and gynecology, pediatrics, cardiology, oncology and emergency medicine. With 33 operating rooms, we offer a full range of surgical specialties and advanced technology that includes the da Vinci Surgical System. Becker's Hospital Review named Banner Desert Medical Center as one of the top 50 busiest Emergency departments in the country.If you aim to deliver top-tier care to the most vulnerable patients, consider joining Banner Children's Hospital at Desert in Mesa, Arizona. Within our over 200 bed, state-of-the-art facility, specially trained nurses, physicians and other clinical professionals utilize the most advanced technology - including iCare ICU monitoring and robotic surgery - to provide high quality, child-friendly, family-centered care. Our facilities feature a 76-bed NICU, a 24-bed PICU, six pediatric ORs and a 22-bed ED. We also offer dedicated pediatric rehab, radiology, oncology and hematology capabilities. With clinical diversity, exceptional training programs and a supportive culture, this is a place where you can grow in your career as you help our very special patients.POSITION SUMMARY
This position facilitates the safe and timely transition of clients from acute care to alternative levels of care such as skilled nursing facility, long-term acute care, inpatient rehabilitation, home infusion therapy, hospice and/or home care or community program. Facilitates discharge plan for the transition of care and services into the designated setting or service. Provides on-site or telephonic discharge arrangements to post-acute and community services.
CORE FUNCTIONS
1. Processes and facilitates the timely discharge/transfer of clients from hospital care to identified post-acute setting. Notifies care coordination team member(s) if patient or caregiver demonstrate or verbalize any inability/concern to be able to manage their post-acute plan or responsibilities.
2. Facilitates/ implements the care plan with proposed interventions in collaboration with healthcare team. Collaborates with all members of the healthcare team to implement, manage and communicate the transition of care arrangements.
3. Participates in performance improvement projects, Banner initiatives and performs data collection for measurement of projects as assigned.
4. Documents all interventions in the patient medical record both timely and accurately including all elements of the discharge plan. Performs transfer of accurate, pertinent patient information between all appropriate entities of the post-acute care continuum.
5. Assist and support patients and families in making appropriate arrangements for the post-acute plan. Performs follow-up calls to patients and providers as indicated and report any concerns to leadership.
6. Serves as an intermediary when providing community resources to patients, caregiver, and families. Discusses with patient, caregiver, and/or family maintaining clear communication regarding anticipated discharge date and potential care settings.
7. Maintains knowledge of Medicare, Medicaid and other program benefits to assist patients with transition of care planning and choices.
8. Employee has freedom to determine how to best accomplish functions within established procedures and implements the discharge plan under the delegated authority of a provider, licensed MSW, registered nurse or other licensed healthcare professional. Confers with supervisor/manager on any unusual situations and communicates plans and activities for patient discharge across the care continuum. Internal customers: Post-acute services team members and all levels of nursing management and staff, medical staff, and all other members of assigned facility interdisciplinary health care team. External customers: home health agencies, nursing homes, insurance providers, group homes, assisted living facilities, hospice, long-term acute care hospitals, inpatient rehabilitation facilities, volunteer agencies, county/governmental agencies and medical supply companies and others as required.
MINIMUM QUALIFICATIONS
A Bachelor's degree in social work or related degree or a Licensed Practice Nurse, or a Licensed Respiratory Therapist required.
Must have knowledge of government/community agencies and resources, such as Medicare/Medicaid, long term care or other applicable resources/services. Must demonstrate eff
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