Case Manager Lic MSW- East- Weekends Only

About the role

The Case Manager is responsible for the assessment, planning, implementation, coordination, monitoring, and evaluation of services across the continuum of care to ensure quality patient outcomes and appropriate utilization of health care services. The Case Manager supports the healthcare team towards a smooth transition from one level of care to another in support of the patient/family.

Responsibilities

• Collaborate with others in a team setting
• Have excellent communication skills
• Support the hospital vision/mission statement
• Confer with nursing staff and other ancillary patient care departments regularly regarding ongoing discharge plans and barriers or delays
• Develop and implement the goal-directed plan of care, prioritized and based on intermediate goals and specific outcome criteria
• Coordinate and facilitate care in a knowledgeable, skillful, and consistent manner
• Document and patient records in a timely, accurate, clear, and concise manner in the transition to quality software
• Record pertinent data in required areas for other team members to provide care/services in an efficient, continuous manner
• Demonstrate awareness and sensitivity to the rights of patients/significant others
• Demonstrate sound knowledge base and actions in the care and decision making for designated patient populations
• Demonstrate responsibility and accountability for own professional practice
• Participate actively in staff development activities for service line care management team, and nursing department personnel
• Collaborate with nurse case manager regarding discharge planning and use of the clinical pathways
• Demonstrate self-directed learning and participate in continuing education to meet own professional development
• Demonstrate awareness of legal issues in all aspects of patient care and unit function
• Participate in management of situations in a manner that reduces risk
• Participate in development and evaluation of the care management team functions
• Participate in meetings, reports, and other activities that support the care management team functions
• Demonstrate effective communication methods and skills, using lines of authority appropriately
• Conduct discharge planning assessments on identified patients that are consistent and provide for continuity of care for the patient
• Establish the discharge plan with the patient, physician, and care management team for identified patients
• Implement the discharge plans for patients to include referrals to home health agencies, return to ECF’s transportation, and any unmet needs to provide safe and appropriate transition to next level of care
• Demonstrate effective problem-solving techniques to communicate openly with members of the care management team and other staff
• Demonstrate skills as a resource and consultant to unit staff, care team members, and other staff
• Demonstrate skills as a resource and consultant to patients, families, and physicians
• Perform comprehensive assessment of patient/family goals as well as assessment of biophysical, psychosocial, environmental, financial, and discharge planning needs
• Procure services and serve as advocate on behalf of patients and families
• Act as a liaison to post-hospital care providers and community health resources
• Demonstrate knowledge and understanding of Medicare, Medicaid, and third party payer guidelines
• Complete all necessary paperwork for final disposition
• Conduct personal interviews with patient, facilitate family conference and multidisciplinary conferences to formulate discharge plans

Qualifications

• LCSW or LSW in the State of Indiana required
• Master’s Degree in Social Work required
• 2+ years of inpatient, outpatient, or home-base social work experience required
• Experience with quality improvement methodology preferred