Social Worker- Care Management

Essential Functions and Responsibilities

• Complete patient assessments to evaluate all social, psychological, or environmental needs related to the impact of admission, diagnosis, treatment, or discharge.
• Provide patient/caregiver with education, information, and referral services.
• Provide patient/caregiver with relevant information about medical illness, behavioral health, insurance coverage, support, and community services.
• Develop plan of care for patients in collaboration with the primary care team. Document in the medical record as indicated and designated case management tool accurately.
• Provide ongoing communication between the patient and health care team to ensure improved patient outcomes and high quality of patient care.
• Conduct end-of-life discussions with patient/family, as needed.
• Facilitate referrals to other disciplines and internal health and community based programs as needed to improve patient outcomes.
• Cookordinate and participate in interdisciplinary patient/caregiver conferences.
• Participate in departmental process improvement initiatives, work on special projects as needed and attend all departmental meetings.
• Serve as an advocate and resource for the patient/caregiver.
• Provide temporary case management to a specified case load.

Qualifications

• Five years or more clinical and care management experience in hospital, home health/hospice, or managed care setting.
• Required: Licensed Social Worker in the state of Ohio.
• Required: Active Ohio driver's license with the ability to travel throughout COPC's service area as needed.
• Required: Previous experience working with Medicaid patients; knowledge of Medicaid rules and regulations.
• PREFERRED: Master's degree in Social Work.
• PREFERRED: Epic EHR system experience.