Medical Social Worker

Job Summary:

The Case Manager is responsible for utilization review and assessing level of care and discharge planning needs in a timely fashion. The case manager collaborates with providers to ensure accurate status orders are present through chart review and multidisciplinary rounds. Discharge plans are developed with the provider, patient and their families'/support persons and ancillary departments to ensure a safe discharge plan is in place and any necessary referrals are made to the appropriate community agencies, post-acute facilities and primary and/or specialty care physicians. The case manager will provide patients and their families and/or support systems with resources to assist with financial, medical and/or social issues they are experiencing. Responsible for assisting patients in the inpatient, outpatient, Family Birth Center, and Emergency Department settings.

Work Hours:

• Dayshift-Full time

• Weekend rotation

• Holiday rotation

Minimum Work Experience

• A social worker with a minimum of 1-year social work experience preferred
• A social worker with 1-2 years' acute care experience preferred

Minimum education

• LSW Required
• LMSW preferred or working towards it.

Required Licenses

• Social Work license in state of Idaho

Required Skills

• Excellent communication skills

• Knowledge of medical terminology

• Ability to be flexible and prioritize work tasks, crisis situations, etc

• Ability to work independently with minimal supervision

• Ability to adapt to frequent changes with insurance demands

• Ability to follow the Case Management Department Standard Operating Procedures

• Ability to work holidays and a weekend rotation

Functional Demands:

Populations served

• Neonate, pediatric, adolescent, adult and geriatric

• All patients regardless of gender, race, ethnic, religious, sociopolitical, demographic, marital and sexual preference groups

• All patients regardless of developmental and physical abilities or mental illness

Environmental

• Regularly exposed to bloodborne diseases. Contact with patients under a wide variety of circumstances. Exposed to unpleasant elements (accidents, injuries, illnesses, and death). Subject to varying and unpredictable situations. Occasionally subjected to irregular hours.

• Organizational Expectations:

• Provides a positive and professional representation of the organization.

• Promotes culture of safety for patients and employees through proper identification, reporting, documentation, and prevention.

• Maintains hospital standard for a clean and quiet environment.

• Maintains competency and knowledge of current standards of practice, trends, and developments in related scope of job role or practice.

• Participates in ongoing quality improvement activities.

• Maintains compliance with organization's policies, as well as established practices, protocols, and procedures of the position, department, and applicable professional standards.

• Complies with organizational and regulatory policies for handling confidential information.

• Demonstrates excellent customer service through his/her attitude and actions, consistent with the standard contained in The Gritman Way.

Essential Functions

• Responsible for identifying patient who are high-risk and assisting with a safe discharge plan that meets the patient's goal

• Responsible for providing medical social service resources to staff and patients in the Emergency Department, Family Birth Center, Medical Surgical Unit and Critical Care Unit

• Responsible for makes the appropriate referrals for post-acute services and/or mandated reporting

• Responsible for timely delivery of the MOON and Imparta forms

• Responsible for utilization review by conducting concurrent reviews using nationally recognized criteria and referring cases appropriately for secondary review and documenting in the UR module per UR Standard Operating Procedures.

• Responsible for submitting clinical and communicating with the insurance companies per their UR guidelines

• Responsible for adhering to HIPAA guidelines and regulation and maintaining patient confidentiality and acknowledging patients' rights on confidentiality issues at all times.

• Responsible for collaborating with the Case Manager-Registered Nurse, hospitalists, nursing staff, House Supervisors, ED, and outside agencies to expedite access and throughput

• Covers for the Case Manager-Registered Nurse during weekend and holiday coverage and when staffing needs arise

Qualifications

Education Required:

Bachelors or better in Social Work or related field.

Experience Preferred:

2 years prior medical experience including customer service experience.