- Cleveland Clinic (Cleveland, OH)
- …Social Workers regarding the discharge planning status of all patients referred by Transitional Care Coordinator . + Determine bed availability at extended ... facilities based upon requests by patients and families and advise the Transitional Care Coordinator and Social Workers of bed opening. + Transmit initial… more
- ProMedica Health System (Toledo, OH)
- …referral/admission/discharge data as appropriate. 6. Provides coverage to Transitional Care Manager, Case Manager, and PPS Coordinator roles with shared ... community. This role actively collaborates with the FRC PPS Coordinator , Case Managers, Transition Care Managers, and...the FRC PPS Coordinator , Case Managers, Transition Care Managers, and Nursing and Therapy Leadership to coordinate… more
- ProMedica Health System (Oregon, OH)
- …Rounds (DTRs) and contributes to discussion of discharge needs. 9. Identifies transitional care barriers and collaborates in comprehensive, patient-centered ... The Social Worker/Discharge Planning Coordinator intervenes with patients who are psychosocially complex,...Health (SDOH) needs, and/or require assistance with transitions of care or discharge planning. In addition, the Social Worker/Discharge… more
- ChenMed (Maple Heights, OH)
- …PCP leads their care team consisting of care promoter (medical assistant), care facilitator, and care coordinator for patients able to come to the ... the office-in hospital, SNF, LTC or homebound, PCP will engage with the transitional care team and others including case managers, acute and transitional -… more
- ChenMed (Columbus, OH)
- …+ Leads their care team consisting of care promoter (medical assistant), care facilitator, and care coordinator for patients able to come to the ... come to the office-in hospital, SNF, LTC or homebound, engages with the transitional care team and others including case managers, acute and transitional -… more