UR/DC Planner at Care New England / Jobsxl

UR/DC Planner

Care New England
in Rhode Island
(Published at 18-11-2019)

Butler Hospital Position: Partial Hospital Utilization Review /Discharge Planner, Per Diem

    • Works with patient and family to assess discharge planning needs.
    • Ensures each patient has a transition plan prior to discharge.
    • Assists patients in exploring barriers to a seamless transition plan.
    • Works with patients to empower them to engage and participate in the transition planning processes, and educates them to the importance of following up with aftercare as part of wellness.
    • Collaborates with families in the transition planning process.
    • Conduct additional groups on the unit as needed.
    • And other duties as assigned.

In collaboration with the team, contributes to defining the need for further resources and services for patients.

  • Is able to communicate data to the treatment team in a clear and concise manner.
  • Participates in team meetings and huddles as needed.
  • Demonstrates understanding of the impact of ethnic, cultural, socioeconomic gender and lifestyle issues.
  • Demonstrates knowledge and understanding of concrete service and discharge planning needs for the adult psychiatric population
  • Picks up patients from admissions area and orients them to the hospital and program.
  • Conducts vital signs on new admissions to the program and documents.
  • Obtains Releases of Information for outpatient providers as directed.
  • And other duties as assigned.
  • Completes documentation of releases, assessment and other appropriate forms within prescribed time frames.
  • Documents significant patient and family encounters as well as contacts with other professionals and community agencies.
  • Notifies outpatient providers of PHP admission and documents
  • Documents educational interventions and responses.
  • Completes Butler Care Planning Discharge documentation in AVATAR prior to patient discharge.
  • Performs all initial reviews of all (100%) cases within 24 hours as assigned.
  • Performs all concurrent review procedures: pre-admission, admission, continued stay and discharge utilizing established hospital criteria as well as criteria set by ERO as assigned.
  • Manages the process of retrospective reviews and appeals according to department policy and external requirements as assigned.
  • Coordinates on site reviews with clinical teams and ERO’s.
  • Manages the process of denial of benefits according to regulatory agency requirements and insures notification of both internal and external customers.
  • Maintains accurate and up to date written and computerized records of all cases and all cases in review.
  • Regularly provides feedback to clinical team on benefits and utilization issues related to case.
  • Maintains computer skills necessary to complete all work.
  • Attends supervision on regular basis and seeks consultation when necessary
  • Participates in own performance appraisal by reviewing progress with department head or designee and by identifying own individual goals in any areas needing improvement.
  • Reviews literature, attends conferences within and/or outside Butler Hospital system to maintain/improve skills and knowledge base.
  • Regularly reviewed department Policy and Procedure Manual
  • Regularly attends yearly Education Fair
  • Is knowledgeable about Risk Management, safety and Infection Control procedures demonstrated by compliance with requirements
  • Consistently adheres to Butler Hospital?s service standards

Job Relationships

§ Reports to: Director of Care Management and Social Services, or Program/Nurse Manager of the PHP

  • Supervises: BSW students as assigned
  • Other Relationships:
  • With Partial team members and Director
  • With other Social Services staff members, including secretarial support staff
  • With chief of unit where assigned
  • With Clinical staff in other areas of the hospital

II. Qualifications

§ Education: BA/BSW/ MSW

§ Training and Experience: Training or experience in a psychiatric facility is helpful

but not absolutely necessary. Trained in Social Work

Training and/or experience relevant to the specific population served is necessary for care planners with primary assignments to specialty units or continuing Education/In-service in that area will be required

  • Special Qualifications: Interest in and commitment to the programs at Butler

Hospital and the Department of Psychiatry and Human Behavior at Brown University

  • Physical and Mental: Able to do a moderate amount of walking and tolerate the stress and multiple demands of working in a fast-paced environment dealing with a multidisciplinary staff and difficult patient population.

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