Complex Case Manager, Social Worker (LMSW)

UT Southwestern Medical Center • Dallas, TX

2d • Onsite

About The Position

The Complex Case Manager, Social Worker (LMSW) is responsible for coordinating care and discharge planning for patients with extended hospital stays and complex medical and psychosocial needs. This role conducts comprehensive psychosocial and discharge planning assessments, identifies patient-centered discharge goals, and collaborates with patients, families, physicians, and interdisciplinary care teams to develop and implement safe, effective transition plans. The Complex Case Manager follows patients throughout their hospitalization, facilitating care coordination and addressing barriers to discharge. This position arranges and coordinates referrals and post-acute services, including durable medical equipment (DME), skilled nursing and rehabilitation facilities, infusion services, community resources, and other support services to ensure individualized discharge needs are met and continuity of care is maintained.

Requirements

• (LMSW) LIC MASTER SOCIAL WORKER licensed in the state of Texas.

Nice To Haves

• 2 years hospital experience

Responsibilities

• Screens and evaluates high risk patients for discharge planning needs.
• Consults with attending physicians and members of the healthcare team regarding any identified psychosocial issues and/or care transition barriers.
• Recognizes that the transition process is collaborative with the multidisciplinary team to include the patient/family and assists with executing the plans and interventions to facilitate the hospital stay and manage length of stay and reassesses as care needs change.
• Facilitates patient care conferences as indicated, to include complex cases to proactively assist with establishing a safe and effective discharge plan.
• Implements the transition of care plan to the next level through appropriate service referrals and assures that the patient is given choice in regards to agencies and services.
• Assists with adoptions, abuse and neglect cases, including assessment and investigation, intervention and referral as appropriate to local, state, and/or federal agencies, as indicated.
• Educates and provides information and resources to patients and families regarding the availability of community resources.
• Interprets patient and family needs and provides information concerning availability and limitation of resources.
• Maintains open communications with community agencies to appropriately assist in referring and meeting patient needs.
• Maintains knowledge of payor benefits, hospital and community resources, and regulatory standards to ensure informed decision making, continuity of care, and desired outcomes (i.e. medical, medical cost, quality of life, and patient satisfaction).
• Maintains chronological notes, clinical charts, statistical data, or case histories for each patient with respect to social problems, adjustments for patient and family involvement, and actions taken or planned.
• Directly interacting with or caring for patients.
• Directly interacting with or caring for human-subjects research participants.
• Regularly maintaining, modifying, releasing or similarly affecting patient records (including patient financial records).
• Regularly maintaining, modifying, releasing or similarly affecting human-subjects research records.
• Performs other duties as assigned.

Benefits

• PPO medical plan, available day one at no cost for full-time employee-only coverage
• 100%25 coverage for preventive healthcare-no copay
• Paid Time Off, available day one
• Retirement Programs through the Teacher Retirement System of Texas (TRS)
• Paid Parental Leave Benefit
• Wellness programs
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF) Qualified Employer

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level