Inpatient Registered Nurse or Social Worker (MSW) Care Manager Opportunities, Full Time, Part Time, Per Diem at Multiple Campuses

St. Luke’s University Health Network•Easton, PA

About The Position

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex discharge planning needs of patients, as well as to provide supportive counseling, psycho-social assessment and interventions for designated patient populations across the continuum of care. Also works with the providers, registered nurse care managers, social workers, and multi-disciplinary care teams to facilitate the achievement of desired patient, quality, and financial outcomes.

Requirements

MSW or equivalent from an accredited school of social work.
Current NJ SW license if working at St. Luke’s Warren Campus.
May hire per diem BSW’s currently in school within 6 months of completing MSW.
If primary coverage area is OB, membership in the National Organization of Perinatal Social Workers is required.
Graduate of professional nursing program.
Registered Nurse with current license to practice in the State of Pennsylvania or seeking Pennsylvania licensure through reciprocity.
NJ RN licensure required for Warren Campus.
Advanced degree preferred.
BSN required or obtained within 3 years of hire, MSN and/or Case Management Certification preferred.
Preference is for at least two years of experience as an RN or Social Worker in an acute hospital setting.
Strong critical thinking skills.
Ability to maintain collaborative and effective working relationships.
Able to assert needs to patients, families, physicians, and other members of the interdisciplinary team while maintaining established rapport and relationships.
Knowledge of medical terminology required.
Ability to communicate both verbally and in written forms.
Basic computer skills required.

Nice To Haves

Previous care management experience is preferred.

Responsibilities

Assesses the patient’s needs, goals, and barriers in relation to the patient’s clinical condition, psychosocial environment, and socioeconomic resources.
Collaborates with the multidisciplinary team to plan, implement and evaluate the patient’s plan of care through rounding or other methods.
Collaborates with the patient, family or other caregivers, and multidisciplinary team to design a discharge plan respective of the patient’s needs and goals.
Re-evaluates and revises discharge plan of care as additional information is obtained or goals change.
Proactively considers options such as palliative care, home care and other services that work to keep the patient as healthy as possible in the outpatient setting, minimizing the risk of re-admissions.
Works as a team with other members of care management, including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director.
Facilitates communication among all treatment team members.
Manages length of stay by proactively identifying and mitigating issues and barriers to care and a successful discharge plan.
Monitors risk assessment using available tools and implements discharge interventions accordingly, minimizing risk of readmission.
Identifies patients with an unplanned readmission and completes root cause analysis.
Collaborates with Outpatient Care Managers to identify patients for handover and post discharge follow up.