Discharge Planner/Social Worker

At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.

Job Summary

• The Discharge Planner plays a vital role in facilitating patient transitions from hospital to post-acute care settings by collaborating with the interdisciplinary healthcare team, patients, and families. They ensure timely discharge planning, compliance with regulatory requirements, and coordination with external agencies to optimize quality of care and resource use. The Discharge Planner serves as a liaison among hospital departments, insurance providers, and community resources to achieve positive clinical and financial outcomes.

Essential Functions

• Coordinates discharge planning processes and supports the Case Management team
• Ensures timely delivery of CMS required notification letters (e.g., Important Message from Medicare, Medicare Outpatient Observation Notice)
• Assists with patient choice documentation and facilitates communication with post-acute providers
• Coordinates logistics such as transportation and home care services under Case Manager direction
• Serves as a liaison between hospital departments, external care providers, and payers
• Participates in interdisciplinary rounds and departmental meetings
• Maintains accurate patient records, updates community resource directories, and tracks department metrics
• Collects data for Utilization Management and other committee reports
• Supports documentation and compliance with reimbursement protocols for commercial and government payors
• Refrains from engaging in direct patient care tasks

Knowledge/Skills/Abilities/Expectations

• Strong critical thinking and decision-making skills
• Effective interpersonal and communication skills with sensitivity to diverse populations
• Basic clerical and computer proficiency, including Microsoft Office applications
• Ability to multitask and remain organized in high-stress environments
• Demonstrates commitment to safety, quality, and customer service
• Constant keyboard data entry, sitting, and auditory/visual attention
• Frequent standing and walking; occasional pushing, pulling, reaching, and lifting light to moderate weights
• Rare bending, squatting, kneeling, and exposure to biological and chemical hazards
• Primarily office and clinical care settings within the hospital
• Occasional exposure to bloodborne pathogens, communicable diseases, and hazardous materials
• Requires adherence to safety standards and HIPAA guidelines in all communications and documentation

Education

• High school diploma or equivalent required
• Bachelor’s degree in a healthcare-related field preferred

Licenses/Certifications

• LPN or BSW preferred
• All credentials required within time frame required by facility policy

Experience

• Minimum 3 years of experience in a healthcare setting, preferably in acute care, home health, nursing home, or hospice
• Previous experience in Utilization Review or Discharge Planning preferred
• Knowledge of medical terminology and community resources required