Social Worker, Case Manager II

Summary

As part of the Care Management team, the Social Worker combines social expertise with knowledge of community resources and applies principles of quality management, discharge planning, and management of clinical/financial resources as a facilitator and consultant to the multidisciplinary patient care team. The Care Manager predicts, facilitates, and evaluates the transition of patients across the care continuum and ensures linkages with post‑acute discharge providers.

• Demonstrates the knowledge base and essential psychomotor skills required to effectively carry out the job.

• Interprets, analyzes, and applies relevant data to prioritize and determine a course of action appropriate to meet patients’ management needs.

• Communicates and collaborates effectively with culturally diverse populations and professional colleagues.

• Demonstrates effective time management and initiative to carry out job responsibilities in a timely manner.

• Assesses, plans, implements, and evaluates strategies to ensure appropriate utilization of clinical resources and management of length of stay.

• Develops, implements, and evaluates discharge plans for assigned patients.

• Meets all organizational requirements and demonstrates initiative to establish and achieve personal and professional goals.

• Demonstrates effective customer service behaviors consistent with the organization’s mission, vision, and values.

• Creates and implements individualized discharge plans for admitted patients, assessing medical, functional, psychosocial, legal/financial, and safety needs.

• Collaborates with physicians, nurses, and ancillary staff to make recommendations for effective patient management.

• Refers patients and families to appropriate resources, including caregivers, equipment, mental health, transportation, medical, housing, and educational services.

• Monitors length of stay and utilization of ancillary resources, identifying opportunities for process improvement.

• Communicates concerns regarding resource utilization, physician needs, and length of stay following the chain of command.

• Provides information regarding denials/approvals and collaborates with physicians and insurance companies to expedite peer‑to‑peer processes for post‑acute care.

• Communicates denials verbally and in writing to patients, families, and physicians as needed.

• Enters all pertinent discharge plan data into designated systems according to policy.

• Participates in clinical performance improvement activities, including readmission interviews, and documents findings in the appropriate systems.

• Interprets and negotiates with state, local, and federal agencies to optimize patient placement in appropriate settings.

• Works within CMSA standards of practice.

• Demonstrates proficiency in job responsibilities within 90 days.

• Participates in at least one organizational committee and reports activities to the department.

• Performs other job duties and projects as assigned.

• Minimum Required
  
  Education:
  
  Master of Social Work required
  Experience
  :
  Minimum of two (2) years of clinical social work experience with one (1) year of Case Management experience required in acute or post‑acute setting such as acute care hospital, post‑acute rehabilitation, home health or community nursing setting. A supervised internship completed in an acute care hospital setting may be considered toward the required experience.

• Certifications: CCM or ACM required within 2 years of eligibility for the exam. CPR certification must be obtained within 6 months and maintained per hospital policy (refer to RQI policy).

Accredited Case Manager

Equal Opportunity Employer
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