Inpatient Care Manager - MSW

Schuylkill•Allentown, PA

4d•Onsite

About The Position

The Inpatient Care Manager - MSW coordinates comprehensive care for a designated patient population across the continuum of care. The role assesses, plans, implements, and evaluates individualized care plans and ensures safe, timely discharge planning. Serving as a clinician, care manager, and educator, the position collaborates with the interdisciplinary team to support high-quality, cost-effective outcomes. The role also manages resources to minimize unnecessary utilization and supports performance improvement initiatives to enhance patient care and system efficiency.

Requirements

Master’s degree in Social Work.
Less than one year of experience in an MSW internship program.
Ability to incorporate strategies for interacting with people from diverse backgrounds.
Ability to set priorities to coordinate care plans efficiently.
Knowledge of computer applications and analytical tools.
Proven leadership skills.
For colleagues working in New Jersey, an LSW or LCSW license is required upon hire.

Nice To Haves

Familiarity with EHRs, especially EPIC.
ACM (Accredited Case Manager) certification from the American Case Management Association within three years, or CCM (Certified Case Manager) certification from the Commission for Case Manager Certification within three years.

Responsibilities

Conduct comprehensive assessments at patient entry to determine anticipated length of stay, discharge needs, and resources; develop and implement individualized care and transition plans with the multidisciplinary team.
Coordinate safe, timely discharge planning, including post-acute authorizations, transportation, homecare, facility placements, and transfers as needed.
Monitor patient progress through daily review and multidisciplinary rounds; identify and resolve barriers to discharge.
Advocate for patients and families, address clinical, educational, and psychosocial needs, and ensure patient preferences are reflected throughout the care continuum.
Collaborate with multidisciplinary healthcare teams and involve patients and families in developing and implementing care plans.
Coordinate team and family conferences when necessary to facilitate care progression.
Refer patients and significant others to community-based services and resources to meet continuum-of-care needs.
Maintain knowledge of Medicare, Medicaid, and other payer benefits, reimbursement methodologies, and conditions of participation.
Educate patients and families to support self-management and adherence to discharge care plans through in-person, telephone, and electronic engagement.
Communicate with physicians, patients, families, and team members to facilitate referrals, authorizations, resolve medical-necessity issues, and coordinate transitions and discharge planning.
Initiate medical assistance applications when needed, ensure applications have been initiated by identified external agencies as needed, and follow up with those agencies.
Support performance improvement initiatives and manage resources to reduce unnecessary utilization.