Case Manager, Social Work, PRN, BSW or MSW

Mary Washington Healthcare•Stafford, TX

5d•$34 - $51

About The Position

The Case Manager, Discharge (MSW) organizes and expedites treatment plans of care for medically complex patients and patients with difficult social issues affecting hospital progression. The role identifies discharge needs, develops and documents discharge plans, promotes communication and coordination among care providers, and provides patients and families with information and education about community resources. The Case Manager coordinates care with clinical partners and provides intervention in child or elder abuse and neglect cases and guardianship matters. The role also serves as a resource for treatment decisions involving end of life and Medical Power of Attorney. The Social Worker (MSW) has advanced training and additional fieldwork supporting work with difficult conversations, client needs assessments, public assistance resources, crisis intervention, and trauma-informed care, and is eligible for the LMSW examination. The position serves as a subject matter resource for the care team and mentors new social work Associates and student interns. It also supports discharge-planning audits and quality improvement activities, addresses discharge delays and barriers with leadership, and provides support for immediate post-discharge needs.

Requirements

Master’s degree in Social Work.
At least one year of social work experience, or a two-semester internship completed within the MWHC Care Coordination department.
Experience with computer technology, including Windows-based programs, email, and Microsoft Word.
Critical thinking and analytical skills; ability to multitask and communicate and collaborate effectively with a multidisciplinary team; ability to cope with difficult situations.
Ability to tolerate irregular hours, including evenings, nights, and weekends.
Ability to meet the stated physical requirements, including lifting 35 pounds and pushing and pulling up to 20 pounds.
Ability to wear appropriate personal protective equipment when required.

Nice To Haves

Experience in a healthcare field preferred.
Case Management Certification strongly desired.

Responsibilities

Coordinate patient care with clinical partners and help patients progress toward realistic and desirable outcomes.
Serve as a subject matter expert and resource for care team members.
Mentor new social work Associates in the Care Coordination department and social work student interns.
Assess long-term and future patient care needs, including probable changes in independence or functional quality.
Communicate treatment-plan activity status updates to clinical partners.
Provide patients and families with information and education about community resources.
Develop, coordinate, communicate, and document discharge plans with patients, families, and the care team for medically complex cases and difficult social issues.
Assist with audits and assessments of discharge-planning documentation and support complex care coordination situations.
Partner with leadership to address discharge delays, barriers, and identified trends.
Serve as a point of contact and resource for immediate post-discharge patient needs.
Intervene in cases involving child or elder abuse or neglect and guardianship.
Provide resources concerning treatment decisions involving end of life and Medical Power of Attorney.
Facilitate interdisciplinary meetings and comprehensive care planning, and delegate work to support team members.
Use post-acute care facilities in safe and effective discharge planning.
Collaborate with contracted financial-needs partners to facilitate placement in post-acute facilities.
Conduct psychosocial assessments as needed to develop appropriate discharge plans for medically complex cases and difficult social issues.
Participate in planning and implementing quality improvement activities.
Perform other duties as assigned.