Discharge Planner Per Diem Days

MLK Community Healthcare; Los Angeles (CA); On-site; USD 34,000 - 49,000; Full time

Job summary

MLK Community Healthcare is seeking a Care Coordinator/Navigator to support discharge planning and post-acute care transitions. The role involves coordinating with physicians, nursing, and community partners to ensure smooth patient trajectories.

The candidate should have 2+ years in health care, strong communication, and knowledge of CMS guidelines. BLS certification and proficiency in Word/Excel are required; bilingual Spanish is a plus.

Qualifications

• High school diploma or GED required.
• Medical Assistant Training preferred.
• Two+ years in a healthcare setting as unit clerk or care coordinator required.
• Knowledge of CMS guidelines preferred.
• Current Basic Life Support (BLS) from the American Heart Association.
• Proficiency with Word and Excel.
• Bilingual Spanish preferred but not required.
• Medicare/Title XX11 benefits knowledge.

Responsibilities

• Advocate for patients and navigate health systems for smooth transitions.
• Coordinate post-acute referrals (home care, SNF, LTAC) based on patient/family choice.
• Communicate discharge plans to patients and families as directed by CM leadership.
• Ensure CMS guidelines and insurance requirements are followed for post-discharge needs.
• Document care transitions accurately in the patient record.
• Coordinate transportation arrangements per insurance requirements.
• Attend rounds and assist with data collection or reporting as needed.

Skills

Multitasking

Oral and written communication

Problem-solving

Bilingual Spanish

Education

High school diploma or GED

Medical Assistant Training

Tools

Microsoft Word

Microsoft Excel

Job description

Position Summary

Manages the discharge/transition process by working closely with the patient and/or family, and coordinating care with the multidisciplinary team: including physicians, nursing, and community based organizations, to ensure patient's adequate post-acute care transition. Applies substantial knowledge and experience to perform a wide range of advanced activities and/or determines how to use resources to meet schedules and organizational goals; serves as lead for team or work group.

Essential Duties And Responsibilities

• Assists patients through the healthcare system by operating as a patient advocate and health systems navigator.
• Coordinates continuity of patient care with external healthcare organizations and facilities.
• Obtains patient choice for post-acute facilities as required by CMS Conditions of Participation.
• Coordinates referrals to post-acute facilities, including home care, DME, SNF, LTAC, Acute Rehabilitation based on patient/family choice when patient has Medicare.
• Coordinates referrals to contracted facilities and vendors for managed care.
• Reports care/discharge barriers to appropriate care manager.
• Follow the continuum of patient care for admission to post-discharge.
• Communicates with patients and families with regard to transition plans, as directed by the Care Manager.
• Promotes clear communication amongst interdisciplinary care team members by ensuring awareness regarding patient care plans.
• Coordinates special needs and projects as assigned (resource manuals, complex placement, recuperative care)
• Knowledge of Medicare guidelines for post-acute needs IE: oxygen, wheelchairs, PT/OT/ST, feeding supplies
• Documents in the patient’s medical record for continuum of care.
• Coordinates transportation arrangements according to insurance requirements or as needed to meet post discharge needs
• Assists with post-acute needs as requested by CM Leadership or RN Case Manager.
• Provides education to patient and/or family in the use of equipment as needed
• Attends Physician or Bedside Rounds as directed by the Case Manager or CM Manager
• May be requested to perform data collection or provide reports
• Take the initiative with delivering care
• Assist with higher level of care
• Performs other duties as assigned.

Position Requirements

• Education
• High school diploma or GED required
• Medical Assistant Training preferred
• Qualifications/Experience
• Two (2) years continuous recent experience in a healthcare setting as unit clerk /care coordinator or similar position required.
• A team player that can multitask and can follow details – knowledge of CMS guidelines preferred
• Highly organized and well developed oral and written communication, problem-solving, and decision-making skills
• Special Skills/Knowledge
• Current Basic Life Support (BLS) for Health Care Providers from the American Heart Association
• Proficient to expert computer skills utilizing Microsoft Office especially Word and Excel
• Critical thinking
• Resourcefulness
• Bi-lingual Spanish preferred but not required
• Medicare conditions of participation, general knowledge of Title XX11 benefits for medi-cal recipients

Compensation

Hourly

Salary Range (Depending on Experience)

$30.28 - $30.28