Hospital Discharge Coordinator RN

Northwest Human Services is a non-profit leader in providing advocacy, quality healthcare and social services in Marion and Polk counties since 1970.  We are a mission focused organization providing compassionate and professional medical, dental, psychiatry, mental health, and wraparound services for those in our community who need it most - uninsured individuals, families, the homeless, and migrant workers.  As a Community Health Center we value a culture of equity, diverse perspectives, and life experiences. Our organization embraces innovation, collaboration, and work-life harmony.

Hospital Discharge Coordinator RN

Location: Northwest Human Services – West Salem Clinic, 1233 Edgewater St. NW, Salem OR 97304

Job Status: Full-time, Monday-Friday, 8am – 5pm

Northwest Human Services (NWHS) is seeking a compassionate and detail-oriented Hospital Discharge Coordinator RN to support seamless care transitions for patients following inpatient and emergency department admissions.

YOUR ROLE:

The Hospital Discharge Coordinator RN monitors hospital and emergency department activity, coordinates post-discharge follow-up appointments, supports medication reconciliation, and collaborates closely with providers and interdisciplinary care teams. This position also supports compliance with HRSA and OAR requirements and helps meet quality metrics related to substance use disorder care.

This position works closely with care providers and team members to ensure patients receive timely and appropriate care, aligning with the Patient-Centered Primary Care Home (PCPCH) model.

SPECIFIC DUTIES:

• Monitor hospital inpatient and emergency department admissions and discharges using PointClickCare


• Coordinate and schedule timely primary care follow-up appointments after ED and inpatient stays


• Collaborate with providers and interdisciplinary care teams to ensure continuity of care


• Review discharge summaries and After Visit Summaries to identify follow-up needs, labs, and referrals


• Educate patients on discharge instructions, medication changes, and care plans


• Update medication lists and support appropriate follow-up and refills


• Monitor ED admissions related to substance use disorder to support quality and IET metrics

QUALIFICATIONS:

• Current Oregon RN license


• 2 years RN experience


• Ability to read and interpret care plans


• Clinic or discharge planning experience required


• 6 months of care/case management experience preferred

SUMMARY OF BENEFITS: Our Agency strives to provides a benefits program that is comprehensive and competitive within our industry.

• Healthcare insurance plans: Medical, Dental, Vision


• Group Life: Short-Term & Long-Term Disability 100% paid by employer


• 403(b) retirement plan with 2% of employer contribution and up to 3% employer match


• Flex Spending Account


• PTO - 10 hours a month for FT positions 40 hrs./wk. up to 20 hours monthly as your tenure grows


• 7½ paid holidays each year + 2 paid floating holidays for FT positions


• Continuing Education & Training Benefits


• Employee Healthy Living Program – Gym Membership & Smoking Cessation

Northwest Human Services sites are eligible for various Provider Incentive Programs through the Oregon Office of Rural Health and National Health Service Corps loan repayment and scholar programs as well as the Rural Practitioner Tax Cred. For more information check out the Office of Rural Health, National health Service Corps, and Public Service Loan Forgiveness websites. NWHS sites have a Primary Care HPSA Score of 18, Dental score of 19, and a Mental Health score of 22.

Why Join NWHS?

At NWHS, your work matters! Join a mission-driven organization dedicated to improving the health and well-being of underserved and resilient communities.  Be part of a compassionate, forward-thinking team that values collaboration, inclusion, and innovation in delivering exceptional services and community support.

TO APPLY:

If you are interested in joining a team that makes a difference in the lives of many, apply online at: Employment (northwesthumanservices.org)

For more information, contact the HR/Recruiting Department at: [email protected] | 503.588.5828

All candidates who receive a written offer of employment will be required to undergo a criminal records check.

Equal Opportunity Employer | We celebrate diversity and are committed to creating an inclusive environment for all employees.