BH Care Coordinator EX
I. Position Function:
The Sr BH Care Coordinator in the Psychiatry Department works effectively under the direction of a clinical supervisor to coordinate discharge planning activities in cases requiring short- and long-term placement.
Assists patients and their families in coping with illness and resolving complex predisposed or incurred, emotional, financial, and environmental difficulties which interfere with obtaining maximum benefits from medical and behavioral healthcare.
II. Job Relationships:
Supervised and/or reportable to the following by job category:
- Director of Care Management
- Clinical Supervisor
- Member of Care Management Team.
- Collaborates with the Care Manager.
Collaborates with the following staff:
- Physicians
- House Staff
- Nursing Staff
- Physical Therapy
- Respiratory Therapy
- Mental Health Workers
- All Departments within the Medical Center
Demonstrates knowledge of developing appropriate discharge plans for treatment and assistance, including a thorough review of the medical records and other relevant documentation and interviews with physicians, health care team, family and involved community agencies.
III. Authority:
Has the authority and responsibility to providing the following services under the direction of a clinical supervisor:
- Collaborate with the Social Worker to plan the delivery of patient care across the continuum
and in the collaboration with the health care team.
- Collaborate the transition of patient along the continuum, discharge,
follow-up, post discharge in selected situations.
- Conduct family meeting to communicate the discharge plan and to provide support/education as needed
- Provides consultation to nursing staff on discharge planning.
IV. A. Responsibilities/Essential Functions:
1.) "Provides superior customer service to internal and external clients, customers, and patients as referenced in the Service Excellence Standards."
Demonstrates excellence in the delivery of patient care services through participation in the clinical programs facilitated by the Social Work Services team.
Effectively coordinates discharge planning activity in cases requiring social work/Care Management team intervention under the direction of a clinical supervisor.
Acts as BH care coordinator under the direction of a supervisor, mobilizing and monitoring all adjunct activities necessary to effect appropriate discharge plans, including securing appropriate services, and supporting patients and families through clarification and communication of the discharge planning process.
Provides consultation to physicians, health care team, and other professionals by providing essential discharge services, step down referrals and post discharge appointments.
Participates in team meetings as appropriate with the social work team.
Is able to devise efficient methods and systems for accomplishing tasks associated with Social Work Services; maximizes time utilization and efficiency; institutes changes in techniques and procedures as required.
Supports department policies, procedures and practices for documentation and providing high quality care, to ensure compliance with the guidelines of the J.C.A.H.O, the Department of Public Health, and other regulatory agencies as required.
Adheres to strict confidentiality guidelines regarding patient information or interdepartmental and intradepartmental matters.
Thoroughly reviews patient charts (as applicable) and always documents services in a neat, timely and complete manner.
Consistently combines ethical judgment with professional skills within the policy and legal framework of the institution; understands the legal, social, economic and political forces which have been brought to bear upon the current health care system and community.
Develops discharge plans based upon functional assessment in collaboration with patient, family, physician and health care team.
Implements discharge plans and arranges for appropriate post-hospital care by referring patients to appropriate transfer facilities or home health/home care agencies under the supervision of a clinical supervisor.
Evaluates community resources for quality and appropriateness and develops and maintains referral and transfer relationships.
Completes Medicare and other application forms as is appropriate.
Provides information/referral services.
Provides consultation to Interdisciplinary Team.
Accesses patient demographic information.
Participates on committees as assigned regarding patient care issues/service enhancement as assigned.
Establishes and maintains appropriate interpersonal relationships with patients, visitors, and other hospital personnel, while ensuring confidentiality of patient information.
Assists in Quality Improvement initiatives as assigned.
Responsible for service and operational excellence of all assigned department activities to ensure the delivery of quality services and/or outcomes required to meet or exceed the expectations of those utilizing or impacted by the department.
Completes progress notes in a timely manner clearly specifying status of plan under the supervision of a clinical supervisor.
Properly uses office equipment.
Assists in monitoring utilizing of supplies.
Assists in maintaining a safe working environment.
Assumes accountability for his/her position and patients (ex. extends self when unusual need arises).
Performs other duties as assigned.
Reports for work on time and gives adequate notice of absenteeism of tardiness.
Routinely undertakes additional tasks when his/her assignment is completed.
Accepts constructive criticism regarding own performance and strives to make improvements.
Adheres to policies established for meals, breaks, dress code, and parking.
Exhibits courtesy, compassion, and respect to patients, families, visitors, physicians and co-workers.
Maintains competencies through:
- Regular participation in continuing education program.
- Demonstrates understanding of fire, disaster plan, and infection control policies.
Motivated and self-directed:
- Carries out responsibilities promptly and in a self-directed fashion.
- Seeks additional learning experiences.
B. Responsibilities/Non-Essential Functions:
V. Reporting Requirements:
Reports all changes involving the coordination of patient's plan of care to the appropriate health care team member either verbally or in writing.
Reports promptly to the Director, Social Work and other appropriate individuals, any deviation in normal operations, or any potential problems which may significantly alter/effect quality initiatives such as clinical standards and L.O.S.
VI. Accountability:
Shall be accountable to clinical supervisor to follow-up the assessment process with care planning, intervention and evaluation (in appropriate patients) consistent with the clinical guidelines.
Shall be accountable under the direction of a clinical supervisor to document discharge planning activities according to policy.
Shall be accountable for maintaining the confidentiality, and security of all Medical Center related, medical staff related and all sources of patient data information.
Shall be accountable for abiding by all relevant Medical Center policies and procedures.
Shall be accountable for appropriately using the computer systems for their support of their discharge activities.
VII. Qualifications:
Minimum Education:
Bachelors of Social Work, Psychology, or Counseling.
Minimum Experience:
At least one year experience providing Medical Social Work services, and discharge planning.
Basic computer skills.
Minimum skills/abilities:
Requires excellent organizational and communication skills in the English language, and preferably in a second language.
The ability to deal with a rapidly changing health care environment and requires excellent interdisciplinary team collaboration skills.
Evidence of continuing professional development.
Ability to identify trends and make connections between care patterns.
Ability to critically think.
Equal Opportunity Employer/Disabled/Veterans
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