Patient Discharge Coordinator (Behavioral Health) (Bachelor's Level)

MUST have a valid drivers license and vehicle.

• Respond to admission notifications 24 hours per day, 7 days per week on a rotating basis.

• Travel to inpatient units within required time frame to engage with clients post-admission.

• Obtain signed release forms and other required documentation from clients and coordinate appropriate follow-up care with the client’s outpatient providers.

• Conduct brief psychosocial intake, entering and scanning notes/documents into the electronic medical record.

• Liaison with clients’ outpatient providers, communicating all relevant information relating to the admission and discharge to the client.

• Maintain daily telephonic contact with the inpatient unit, visiting the unit as assigned by the Clinical Manager.

• Observe clients pre and post-discharge, communicate with the inpatient treatment team, obtain updated medication lists, and firm discharge dates, where appropriate.

• Complete discharge document(s) and all required reports, uploading them into the client’s electronic medical record.

• Transport clients to fill prescriptions, review reasons for taking medication and provide transportation to clients’ place of residence.

• Schedule interval visits to clients’ home or place of residence, as assigned, following the discharge date until the psychiatric appointment has been kept.

• May perform other duties as assigned.

SPECIALIZED KNOWLEDGE AND SKILLS REQUIREMENTS

• Coordinate behavioral health care, substance abuse, and health care services informed by evidence-based clinical practice guidelines, including prevention of mental illness and substance use disorders.

• Coordinate access to preventive and health promotion services.

• Coordinate access to chronic illness management, including self-management support to individuals and their families.

• Advocates for and supports the client, engage with community agencies/health care providers and others on his or her behalf to ensure access to services needed to increase wellness self-management and reduce emergency room visits and/or hospitalizations.

• Provides clinical support to the Team by providing consultation, education, information around psychosocial and/or substance abuse conditions, interventions and resources to maintain focus on outcomes and best practices.

• Provides interventions for consumers, including but not limited to: skills development; crisis intervention; substance abuse assessment, education, and referral; financial management; household management and preventative maintenance; preventive health; preventive mental health; educational/vocational assessment and planning; resource generation.

• Develops linkages with other support systems.