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Sr Onsite Discharge Planner - Behavioral Health
Durham, NC
Job Description
Job DescriptionThe Sr Onsite Discharge Planner is a hybrid role involving remote and onsite work in one or more NC behavioral health facilities to coordinate the care and services of inpatient members from time of admission to discharge. The Sr Onsite Discharge Planner is responsible for assessing members' needs, creating comprehensive discharge plans, coordinating post-discharge resources and care (including referral to community-based and Blue Cross NC programs as needed), monitoring and/or managing Utilization Management processes, and performing varied senior-level functions to include oversight of program performance.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities.
What You'll Do
- Commute and work onsite as needed at Raleigh-based behavioral health facilities.
- Act as a subject matter expert (SME) to support clinical staff as first point of contact with clinical and/or process questions. Please note: This position does not involve any performance discussions with staff or initiating any disciplinary action.
- Identify and monitor newly admitted Blue Cross NC members to proactively plan toward discharge.
- Assume a collaborative role with all members of the care team, including members and their caregivers, family members, facility staff, and internal Blue Cross NC staff.
- Perform an assessment of each member's behavioral health status and level of support needs.
- Develop a member-centric discharge plan which includes a self-management plan tailored to member's needs, linkage to community-based resources and care, referral to Blue Cross NC programs, and identification of barriers to following discharge plan.
- Support with identifying in-network providers, scheduling follow-up appointments, educating on benefits, and addressing social drivers of health and access to care issues.
- Serve as a liaison between the facility's Utilization Review and Blue Cross NC's Utilization Management teams, communicating and/or evaluating medical necessity criteria, continued stay needs, and appropriateness of services.
- Facilitate warm handoff between members and Blue Cross NC's Behavioral Health Case Management staff via video conference for ongoing support and management.
- Document all aspects of the discharge planning process in health records as required and provide copies of the discharge plan to all members of the care team.
- Facilitate all correspondence related to discharge planning and obtain consents as indicated.
- Actively monitor program identification, engagement rates, and performance metrics to address any issues identified.
- Collaborate with leadership team to develop strategies and identify any adjustments needed to meet established goals.
What You'll Bring (Hiring Requirements)
- LMSW, LCSW, LPC, LMFT, or RN with current unrestricted NC license
- 3+ years of clinical experience in the behavioral health field
- Proven expertise in discharge planning, case management, and/or utilization management processes
Salary Range
$69,000.00 - $124,200.00Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities.
Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Experience
3+ years
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