Social Work Case Manager

AcuteCare Health System LLC•Columbus, OH

15h

About The Position

SUMMARY: The Social Work Case Manager is responsible for providing comprehensive care coordination, advocacy, and support to program participants and their families. This role involves assessing participants' social, emotional, and environmental needs, developing individualized care plans, and connecting participants to community resources and services. The Social Work Case Manager collaborates closely with the interdisciplinary team (IDT) to ensure participants' care plans address their holistic needs, promote independence, and enhance their quality of life. This position requires strong organizational, communication, and problem-solving skills, as well as a commitment to delivering participant-centered, high-quality care.

Requirements

Bachelor's degree in social work or related field
Experience working on an interdisciplinary team in a hospital, nursing home or community-based setting is preferable.
1 year of experience working with a frail or elderly population preferred.
Must have reliable transportation, a valid driver's license, and the minimum state required liability auto insurance.
Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact.

Responsibilities

Support the implementation of participants’ care plans and act as a liaison between participants, caregivers, community agencies, and the interdisciplinary team (IDT).
Coordinate participant admissions and discharges to healthcare facilities, temporary respites, or permanent placements, including referrals to housing options and accompanying participants as needed.
Provide education and ongoing support to participants and families regarding PACE services, resources, and benefits, including Social Security, Medicaid, and Medicare applications and renewals.
Assist participants in maintaining housing and independence through interventions, home visits, and collaboration with caregivers and housing providers.
Offer guidance to team members on topics like dementia, behavioral challenges, and care strategies.
Manage documentation of clinical services, including placements, hospital admissions/discharges, home visits, and significant events, adhering to PACE requirements.
Assist participants and caregivers with grievances, appeals, and maintaining Medicaid eligibility.
Facilitate transitional care in the event of program termination, ensuring continuity of services and referrals to other providers.
Provide case management services and coordinate appointments between social service staff and participants.
Perform administrative tasks such as filing, scanning, faxing, and mailing documents.
Follow organizational policies, safety guidelines, and confidentiality standards to maintain a safe and compliant work environment.
Participate in Quality Improvement initiatives, continuing education, training, and maintaining professional certifications.