Case Manager MSW
About The Position
Assesses, develops, implements, and monitors a comprehensive plan of care through an interdisciplinary team process in conjunction with the patient and family in internal and external settings. Comprehensively assesses patients' goals as well as their biophysical, psychosocial, environmental, functional, and financial status. Procures services and serves as advocate on behalf of patients and families for scarce resources. Directs families to arrange for services which require patient/family decision and participation. Acts as liaison to post-hospital care providers and community health resources. Communicates continually with patients, families, medical and hospital staff, caregivers, and post hospital resources. Facilitates or provides necessary patient and family education prior to admission, during hospital stay, and after discharge as indicated. Develops and maintains a positive work climate and positive working relationships with patients, families, medical and hospital staff, post hospital care providers and community agencies.
Requirements
- Graduate of an accredited school of social work, nursing or related medical occupation
- Active Oregon MSW License
- Previous clinical experience in an acute care setting, or home health setting assessing skilled social services needs and care, equipment and health maintenance resource needs.
- Ability to work with culturally diverse population.
- Must demonstrate the knowledge and skills necessary to assess and plan for post-hospital needs appropriate to neonatal, child, adolescent, adult and geriatric patients.
- Must demonstrate knowledge of the principles of growth of development over the patient's life span, the ability to assess data reflective of the patient's status, and interpret the appropriate information needed to identify each patient's requirements relative to his/her unique needs.
- Presents self positively on the phone and in person.
- Conveys empathy and compassion in conversation.
- Relates to others in a manner which creates a sense of teamwork, cooperation and confidence.
- Works independently and completes assignments as scheduled or communicates barriers to timely completion to manager.
- Recognizes the rights and responsibility of patient confidentiality and handles information appropriately.
- Communicates effectively with people from a variety of socio-economic backgrounds, taking their cultural and spiritual values into consideration.
- Relates well to children, adolescents, adult and geriatric clients.
Nice To Haves
- MSW
- Case Management Certification
- Previous discharge planning and/or case management experience.
- Bilingual and/or English Spanish speaking preferred.
Responsibilities
- Conducting comprehensive psychosocial assessments
- Facilitating communication between patients, families, and healthcare providers
- Coordinating transitions between care settings (hospital to home, rehab, long-term care)
- Evaluating client needs, strengths, and available resources
- Addressing barriers to care (financial, social, logistical)
- Identifying risk factors and immediate concerns
- Monitoring length of stay and identifying potential discharge barriers
- Ensuring appropriate use of healthcare resources
- Developing individualized care plans with measurable goals
- Establishing timelines for interventions and support services
- Regularly reviewing and updating plans based on client progress
- Connecting clients with appropriate community resources
- Facilitating referrals to specialized services (housing, healthcare, legal aid)
- Advocating for clients with service providers and systems
- Representing client interests within complex service systems
- Ensuring clients receive entitled benefits and services
- Addressing barriers to service access
- Responding to emergency situations
- Implementing safety plans
- Providing immediate support and stabilization
- Maintaining accurate, detailed, and timely documentation
- Managing caseloads efficiently
- Participating in team meetings and care coordination conferences
- Ensuring compliance with legal and ethical standards
- Completing required reporting for funding sources
- Engaging in continuing education
- Staying current with evidence-based practices
- Participating in clinical supervision
- Maintaining licensure requirements
- Supports the hospital mission, vision, values, policies, and procedures.
- Participates in required education for DNV programs as applicable to position.
- Performs other related duties as assigned.
Benefits
- Employer paid Medical, Dental & Vision benefit premiums!
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
