Demand planner Jobs in Memphis, TN

A Brief Overview

Provides, coordinates, and implements proactive patient centered discharge planning in coordination with patient / family, providers, and members of the multidisciplinary team. Assist with organizing services across provider lines and systems to affect optimal patient outcomes, continuity of care, and reduce cost.

What you will do

• Patient Progression :
• Perform high level assessments to identify discharge needs and barriers for complex patients.
• Determine details of simple versus complex discharge; outline clear responsibilities for each level.
• Proactively identifies and removes barriers that impede the progress of care.
• Provides on-going assessment / communication with patient / family and interdisciplinary staff to identify and resolve potential barriers to discharge.
• Keeps patient / family informed of care plan
• Update white boards with discharge planning.
• Participates in daily "Status-Now-Action-Planning" (SNAP) Huddles.
• Participates in multidisciplinary rounding and coordination of services.
• Makes appropriate referrals to the Social Worker.
• Revenue Cycle :
• Facilitates facility-specific discharge appeal process.
• Obtains authorization for post discharge needs.
• Compliance with payor requirement
• Post-Acute Placement, Transportation, DME, Home Health, etc.
• Identify potential cases for initiation of notices of non-coverage and advance beneficiary notice.
• Negotiates with payors regarding available options for continued care of the patient.
• Maintains working knowledge of Medicaid, Medicare, and commercial insurance coverage for referred products and services.
• Discharge Coordination :
• Serves as a consultant and educator regarding status, placement, ambulatory care, payor requirements, and utilization of resources.
• Provides leadership to the health care team with an emphasis on coordination of patient care and discharge planning.
• Coordinates patient / family conferences
• Provide / Review forms and ensures proper authorization / certification / signatures to facilitate patient care, including :
• Authorization / certification for patients undergoing surgery, procedures, or diagnostics.
• Physician's signature on applicable documents (i.e. insurance forms, FMLA forms, disability forms, and home health referral).
• Authorization for outside medical purchased services.
• Proficiently uses modules of the Care Logistics system and assist with management of anticipated, pended, and ready discharges.
• Professionalism :
• Provides clear, concise, timely written documentation and updates information and computer data as required.
• Prepares and maintains required reports, records, and files for operational, administrative, and compliance purposes. Utilizes computer and information systems to enter format and retrieve data, generate statistics, computations, tables, charts, and graphs.
• Maintains professional credentials and education necessary to keep abreast and maintain a current knowledge of clinical / theoretical / case management principles, concepts and techniques, best practices, and current trends. Attends continuing education, staff development, and mandatory programs.
• Participates in staff training and performance improvement activities and utilizes the results of the quality of care activities to initiate changes in practices. Participates in orientation of medical staff, residents, and students to promote an understanding of the admission, throughput, and discharge process.
• Provides data for research and administrative support for case management operations, special projects, and studies.

Qualifications

Physical Demands

Regional One Health is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.