Patient Care Manager - LLMSW or MSW

Munson Healthcare•Cadillac, MI

10h

About The Position

The Patient Care Manager facilitates progression of care and monitors patient progress to ensure that care plans and services are patient-focused, high quality, evidence-based, appropriate, efficient, and cost-effective. The manager applies Relationship-Based Care principles, supports unit action plans, and uses effective customer service and interpersonal skills. The role requires working knowledge of utilization management, managed care, and payer issues that may affect care. The Patient Care Manager responds to case-management screening referrals, identifies community resources, and collaborates with patients, families, multidisciplinary teams, and community agencies to achieve patient outcomes. The manager advocates for appropriate levels of care, encourages patient and family participation in treatment decisions, and educates the healthcare team on access to and use of care settings. The position also supports discharge planning, post-acute services, utilization review, quality improvement, and appropriate resource use. The role may include training and orienting department employees and students, as well as other assigned duties.

Requirements

Master of Social Work (MSW) required.
Minimum LLMSW limited license required at the time of hire.

Nice To Haves

Recent hospital patient care experience.
Knowledge of hospital operations.

Responsibilities

Facilitate progression of care and monitor patient progress to promote appropriate, high-quality, evidence-based, efficient, and cost-effective care.
Respond promptly to screening referrals for case management services.
Identify appropriate community resources and collaborate with patients, families, multidisciplinary teams, and community agencies to achieve desired outcomes.
Confirm admission diagnoses and identify related quality and care metrics to promote medical compliance.
Advocate for patients by assessing whether their healthcare needs are addressed at the most appropriate level of care.
Encourage and facilitate patient and family participation in care and treatment decisions.
Educate healthcare team members about appropriate access to and use of different levels of care.
Identify patients at risk for readmission and refer them for community-based follow-up; recognize and respond to readmission or psychosocial risk factors.
Consult with the physician advisor as needed to resolve progression-of-care barriers through appropriate administrative and medical channels.
Serve as a primary liaison among physicians, patients, families, payers, external case managers, and the interdisciplinary clinical team.
Participate in complex-patient discharge planning to support timely discharge and linkage with post-discharge care providers; refer appropriate cases to the Complex Discharge Planner.
Collaborate with Post-Acute Coordinators to monitor and facilitate completion of complex post-acute services.
Coordinate with utilization review specialists regarding admission eligibility, continuing stay, and readiness for discharge under medical necessity guidelines, including InterQual criteria.
Work to influence clinical and financial outcomes of care.
Identify and record preventable delays or avoidable days caused by failures in progression-of-care processes.
Participate in quality improvement activities and departmental research or studies as requested by the department manager.
Manage resource utilization while navigating patient movement along the continuum of care.
Collaborate with social workers, counselors, and Resource Center coordinators to research discharge placement options when home discharge is not possible, considering patient and family goals, team recommendations, payer benefits, and private financial considerations.
Consult the Program Manager, Director, and Medical Advisor for guidance on physician and Resource Management issues.
Work with the Resource Center and providers to determine patient eligibility for post-acute services.
May assist with training and orientation of new department employees and students.
Perform other duties and responsibilities as assigned.