Discharge & Care Transition Specialist

Astoria-Healthcare-Center; Los Angeles (CA); Sur place; USD 70 000 - 90 000; Plein temps

Résumé du poste

Astoria Healthcare Center in Sylmar is seeking a compassionate and organized Discharge Planner to support residents through the discharge process at our skilled nursing facility. You will coordinate safe transitions to the next level of care, working closely with residents, families, and the interdisciplinary team to ensure smooth and compliant discharge planning.

The role requires prior SNF experience and strong communication, organizational, and problem-solving skills.

Qualifications

• Previous experience working in a skilled nursing facility (SNF) is required.
• Experience in discharge planning, social services, case management, or care coordination is strongly preferred.
• Knowledge of discharge planning procedures, community resources, and post-acute care services.
• Strong communication, organizational, and problem-solving skills.
• Ability to work collaboratively with an interdisciplinary team.
• Ability to manage multiple responsibilities and meet deadlines.
• Proficiency in computer systems and clinical documentation.
• Compassionate, resident-centered approach to care and communication.

Responsabilités

• Coordinate and facilitate discharge planning for residents transitioning from the facility to home or another care setting.
• Assess residents' discharge needs and identify appropriate resources and services to support a safe transition.
• Collaborate with the interdisciplinary team, including nursing, physicians, rehabilitation, and social services, to develop and implement discharge plans.
• Communicate with residents and families regarding discharge arrangements, recommendations, and available resources.
• Coordinate referrals to home health agencies, community resources, durable medical equipment providers, and other post-discharge services as needed.
• Assist residents and families with understanding follow-up care instructions and discharge recommendations.
• Maintain accurate, timely documentation related to discharge planning and coordination.
• Participate in care plan meetings and interdisciplinary team discussions as appropriate.
• Identify potential barriers to discharge and work with the care team to develop solutions.
• Ensure discharge planning activities follow facility policies and applicable regulations.
• Maintain confidentiality and demonstrate professionalism when working with residents, families, and healthcare professionals.

Connaissances

Discharge planning

Care coordination

Interdisciplinary teamwork

Communication skills

Organizational skills

Problem solving

Documentation

Outils

Clinical documentation systems

Description du poste

Astoria Healthcare Center in Sylmar is seeking a compassionate and organized Discharge Planner to support residents through the discharge process at our skilled nursing facility. You will coordinate safe transitions to the next level of care, working closely with residents, families, and the interdisciplinary team to ensure smooth and compliant discharge planning.

The role requires prior SNF experience and strong communication, organizational, and problem-solving skills.