Care Coordination Specialist: Discharge & Transitions

Optum; Presque Isle (ME); On-site; USD 50,000 - 89,000; Full time

Benefits offered by this job

Comprehensive benefits

401k contribution

Equity stock purchase

Job summary

Optum is seeking a hospital-based social work professional in Maine to support transition of care planning, discharge coordination, and post-discharge resource placement. The role requires a Bachelor's degree and Maine LSW license, with responsibilities spanning data collection, family engagement, and multidisciplinary collaboration.

The position emphasizes adherence to regulatory requirements and care management evolution, aiming to optimize patient outcomes and resource utilization in a

Qualifications

• Bachelor's degree required and licensed to practice in Maine (LSW)

Responsibilities

• Assessment of physical, psychosocial, and economic needs for transition of care planning to varying levels of care
• Documents, verifies, and validates data required to monitor and evaluate interventions and outcomes
• Interviews and collects patient data and reviews charts related to admission and discharge
• Communicates telephonically and electronically with outpatient providers to enhance continuum of care
• Follows hospital policies, procedures, and applicable laws and regulatory requirements
• Leads coordination of patient-centered care across the continuum and develops safe discharge plans with patients, caregivers and the healthcare team
• Maintains knowledge of care management, utilization review changes, and regulatory requirements; serves as an educational resource to Health System staff
• Assists in determining DRG length of stay, patient experience, and reimbursement
• Promotes patient advocacy in an independent care model
• Engages patient families and interdisciplinary team in discharge process for post-acute resources
• Participates in areas of expertise to advance social work within the hospital
• Performs duties related to discharge planning (e.g., options forms, agency referrals)
• Performs other duties as assigned or required

Education

Bachelor's degree

LSW license (Maine)

Job description

Optum is seeking a hospital-based social work professional in Maine to support transition of care planning, discharge coordination, and post-discharge resource placement. The role requires a Bachelor's degree and Maine LSW license, with responsibilities spanning data collection, family engagement, and multidisciplinary collaboration.

The position emphasizes adherence to regulatory requirements and care management evolution, aiming to optimize patient outcomes and resource utilization in a