Social Work Care Mgr I IP

Emory Healthcare•Atlanta, GA

1d•Onsite

About The Position

The Social Work Care Manager I (SW CM I) is responsible for patient care coordination from admission through discharge, ensuring smooth transitions of care as the patient is discharged from the hospital setting. This role ensures and facilitates high-quality clinical and cost outcomes, procures and secures post-acute services, and coordinates and advocates for patients and families with both internal and external stakeholders. The SW CM identifies and addresses potential barriers to care coordination/discharge planning to foster efficient care delivery and maximize reimbursement. The SW CM begins the process of care coordination at the time of the patient's admission by completing a thorough admission assessment and/or psychosocial assessment, which allows for a timely and accurate capture of information and facilitates the initiation of a discharge plan. The SW CM is an integral part of the interdisciplinary care team, required to attend rounds, care conferences, and/or care team meetings. The SW CM acts as a representative of both the hospital care team and the patient/family, balancing patient/family choice and projected care coordination needs with the ability to execute such services. The SW CM works with the hospital care team and the patient/family to plan and implement the best possible plan for the patient, considering various factors, limitations, and patient/family preferences. The SW CM identifies post-acute services and completes referrals to appropriate post-acute care providers in a timely manner, coordinating directly with the patient/family and the care team. Through continuous assessment and review, the SW CM applies critical thinking to ensure alignment and appropriateness of post-acute services as the patient clinically progresses throughout their stay. Ultimately, the SW CM is responsible for ensuring the discharge plan is aligned to be executed with the patient's medically cleared for discharge date and the projected length of stay as provided by the payor. The SW CM identifies and participates in the development of strategies to reduce unnecessary length of stay and/or resource consumption. The SW CM escalates cases, as appropriate, to management, Physician Advisor, Complex Care team, and/or Ethics committee. The SW CM educates patients/families and the care team regarding post-acute services, transitions of care, readmission mitigation, appropriate post-acute level of care choices, and available resources. The SW CM provides supportive and therapeutic communication for patients, families, and loved ones experiencing anxiety or stress due to illness, injury, or physical limitations. The SW CM responds to suspected violent, assault, abuse, and/or neglect cases in accordance with social work professional ethics. The SW CM must communicate confidently, effectively, and therapeutically while being assertive and conveying an impression that reflects favorably upon the organization. In collaboration with Utilization Review, the SW CM initiates and facilitates discussions with payors to advocate on behalf of the patient and hospital to reduce non-covered, non-authorized, or denied services. The SW CM serves as a resource to the Physician, Interdisciplinary Care Team, and patient for the interpretation of external regulations and organizational policies and procedures pertaining to Discharge Planning and Care Coordination. The SW CM ensures compliance with all regulatory requirements related to Government and Commercial Payors, third-party payers, and federal and state regulatory agencies. The SW CM ensures proper use of Case Management Systems and workflows.

Requirements

Masters in Social Work from an accredited Institution
Working knowledge of software/Eemr applications
Meet all quality and productivity expectations
Successfully complete yearly competencies

Nice To Haves

1 year recent healthcare experience
Experience in Acute Care setting
ACM, CCM preferred

Responsibilities

Patient care coordination from admission through discharge
Ensuring smooth transitions of care
Procuring and securing post-acute services
Coordinating and advocating for patients and families
Identifying and addressing potential barriers to care coordination/discharge planning
Completing thorough admission assessment and/or psychosocial assessment
Attending rounds, care conferences, and/or care team meetings
Planning and implementing the best possible plan for the patient
Identifying post-acute services and completing referrals
Applying critical thinking to ensure alignment and appropriateness of post-acute services
Ensuring the discharge plan is aligned for execution
Identifying and participating in strategies to reduce unnecessary length of stay and/or resource consumption
Escalating cases as appropriate
Educating patients/families and the care team
Providing supportive and therapeutic communication
Responding to suspected violent, assault, abuse, and/or neglect cases
Initiating and facilitating discussions with payors
Serving as a resource for interpretation of regulations and policies
Ensuring compliance with regulatory requirements
Ensuring proper use of Case Management Systems and workflows