Transitional Care Associate

Transitional Care Associate

Banner University Medical Center - South Campus, houses the only Level 1 Academic Medical Center in Tucson meeting the needs of the SMI population. The Behavioral Health Pavilion is also the largest inpatient psychiatric service in Southern Arizona. Our team provides patients a safe, supportive environment that fosters healing and facilitates a return to the highest possible level of independence.

As a Transitional Care Associate, you will assist with case management and executing successful discharge planning. This includes coordination of care within the community to connect patients with resources for Behavioral Health, scheduling transportation, and completing ART meetings. The caseload is typically 8-12 patients and you will complete group sessions once a week.

This is a Full Time, Day Shift position: Monday - Friday 8AM-4:30PM, no weekends. 1 holiday a year.

Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.

POSITION SUMMARY This position facilitates the safe and timely transition of clients from acute care to alternative levels of care such as skilled nursing facility, long-term acute care, inpatient rehabilitation, home infusion therapy, hospice and/or home care or community program. Facilitates discharge plan for the transition of care and services into the designated setting or service. Provides on-site or telephonic discharge arrangements to post-acute and community services.

CORE FUNCTIONS 1. Processes and facilitates the timely discharge/transfer of clients from hospital care to identified post-acute setting. Notifies care coordination team member(s) if patient or caregiver demonstrate or verbalize any inability/concern to be able to manage their post-acute plan or responsibilities. 2. Facilitates/implements the care plan with proposed interventions in collaboration with healthcare team. Collaborates with all members of the healthcare team to implement, manage and communicate the transition of care arrangements. 3. Participates in performance improvement projects, Banner initiatives and performs data collection for measurement of projects as assigned. 4. Documents all interventions in the patient medical record both timely and accurately including all elements of the discharge plan. Performs transfer of accurate, pertinent patient information between all appropriate entities of the post-acute care continuum. 5. Assists and support patients and families in making appropriate arrangements for the post-acute plan. Performs follow-up calls to patients and providers as indicated and report any concerns to leadership. 6. Serves as an intermediary when providing community resources to patients, caregiver, and families. Discusses with patient, caregiver, and/or family maintaining clear communication regarding anticipated discharge date and potential care settings. 7. Maintains knowledge of Medicare, Medicaid and other program benefits to assist patients with transition of care planning and choices. 8. Employee has freedom to determine how to best accomplish functions within established procedures and implements the discharge plan under the delegated authority of a provider, licensed MSW, registered nurse or other licensed healthcare professional. Confers with supervisor/manager on any unusual situations and communicates plans and activities for patient discharge across the care continuum.

MINIMUM QUALIFICATIONS A Bachelor's degree in social work or related degree or a Licensed Practice Nurse, or a Licensed Respiratory Therapist required. Must have knowledge of government/community agencies and resources, such as Medicare/Medicaid, long term care or other applicable resources/services. Must demonstrate effective communication and customer service skills, human relation skills and time management skills. Must be able to work flexible hours and work weekends on rotation. BLS required.

PREFERRED QUALIFICATIONS Previous experience in health care service setting, interacting with patients and families, usually obtained through work in social services, as a licensed practical nurse or in a discharge planning setting. Additional related education and/or experience preferred.