Job Summary: The SNF Discharge Patient Engagement Coordinator will work closely with the Patient Engagement Manager to facilitate the discharge process for short-term skilled nursing facility patients. This role is essential in establishing relationships with patients and their families, ensuring they are informed and prepared for follow-up care after discharge. The coordinator will play a key role in managing care transitions to home care services and providing education to patients about their post-discharge plans.
Key Responsibilities: Assist in developing relationships with patients and families to ensure a smooth transition from the SNF to home care. Coordinate the discharge process, including scheduling follow-up appointments and arranging home health services. Educate patients and families on discharge plans, including medication management and post-discharge care instructions. Collaborate with healthcare teams to gather and communicate necessary patient information for continuity of care. Identify and address any barriers that may affect a patient's discharge or transition to home care. Maintain accurate and up-to-date records of patient interactions and care plans in accordance with facility policies. Participate in team meetings and contribute to continuous improvement initiatives in the discharge planning process. Qualifications: Bachelor's degree in Nursing, Social Work, or a related field (preferred). Experience in discharge planning or patient education (minimum of 2 years preferred). Strong interpersonal skills with the ability to communicate effectively with patients and families. Knowledge of community resources and services for post-discharge care. Excellent organizational skills and attention to detail. Ability to work collaboratively within a multidisciplinary team.