• Culture – At UnityPoint Health, you Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve.
• Benefits – Our competitive Total Rewards program offers benefits options like 401K match, paid time off and education assistance that align with your needs and priorities, no matter what life stage you’re in.

• Diversity, Equity and Inclusion Commitment – We’re committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation.
• Development – We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience.
• Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve.

Discharge Planning

• Facilitates the coordination of discharge planning to assure excellence in patient care and patient flow
• Assess patient’s clinical and psychosocial needs, identifies risk factors and develops plan based on identified needs
• Identifies needed interventions, communicates and collaborates with physicians and primary nurse to individualize plan of care
• Collaborates with patient, family, and other members of the healthcare team to address patient needs related to care coordination
• Coordinates and facilitates interdisciplinary planning and communication through care coordination rounds, complex care meetings, unit specific staff meetings
• Facilitates meetings with patients, significant others, and providers to ensure participation in the plan of care and discharge planning
• Researches and facilitates referrals to appropriate community agencies
• Identifies need for POA or advance directives and assists with completion of AD documents
• Coordinates orientation for the patient to the services and outcomes predicted

Regulatory

• Adheres to the requirements of CMS, The Joint Commission and other payers related to coordination of care, discharge planning, patient interventions and documentation
• Develops, maintains, and performs utilization management in the provision of medical necessary services, determine appropriate level of care for discharge planning, and efficient use of resources
• Communicates with UM Specialist to ensure medical necessity and appropriate patient class for hospital stay and qualifications met for next level of care
• Document all necessary components related to discharge planning in the electronic medical record.

Quality

• Through appropriate discharge planning, monitor quality assurances such as patient experience, length of stay, and reduction of readmissions
• Collaborates with team members in planning and implementation of strategies to manage length of stay and prevent readmissions
• Assists in constructive evaluation of departmental services through participation in the Quality Improvement projects and implementation of systems to increase effective case management by all members of the health care team
• Maximizes positive financial outcomes for patients and hospital by reviewing medical record and making recommendations as needed to insure appropriate coordination of care, length of stay, discharge planning, and quality of care

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  Master’s Degree in Social Work required.

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  1-2 Years post graduate experience.

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  Social Work license in Iowa and Illinois required. (License in second state must be obtained within 30 days of hire.)

• CPR

• Valid driver’s license when driving any vehicle for work-related reasons.

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  Must have thorough knowledge of community resources and agencies.
• Must have excellent communication skills, both oral and written including the ability to communicate with physicians, hospital staff, patients, families and community agencies.
• Requires the ability to negotiate and establish effective working relationships with members of the interdisciplinary health care team.
• Must demonstrate ability to identify and act upon psychosocial needs and work independently in outcome oriented environment.
• Above average computer skills and software programs required.