SOCIAL WORKER MSW - ED

Independence Health System • Greensburg, PA

2d • Onsite

About The Position

The ED Social Worker assesses, coordinates, facilitates, and negotiates services and resources for Emergency Department patients to support appropriate clinical and financial outcomes. The role reviews clinical criteria for ED and direct-admission patients to determine the appropriate level of care, using InterQual Level of Care criteria. The Social Worker discusses level-of-care recommendations with ED and attending physicians and explains care options to patients and families.

The role coordinates discharge planning and post-ED or post-hospital services, including referrals for personal care, skilled nursing facilities, home health, durable medical equipment, transportation, and community-based services. It provides psychosocial support and limited therapeutic, goal-directed counseling, connects patients and families with community resources, and supports case-management follow-through when needed after normal business hours.

The Social Worker collaborates with physicians and the healthcare team to progress plans of care, supports utilization and denial management, tracks avoidable or delay days, and documents interventions in recognized databases. The role also promotes Lean principles and continuous work-process improvement, participates in professional development, and maintains ethical conduct and confidentiality.

Requirements

• Master’s degree in Social Work.
• Three years of recent experience in an Emergency Department, Utilization, or Case Management in healthcare.
• Strong leadership ability, good organizational skills, independent and critical-thinking skills, sound judgment, and knowledge of legal aspects and liability of nursing practice.
• Act 33 clearance with renewal.
• Act 34 clearance with renewal.
• Act 73 FBI Clearance with renewal.
• Ability to perform the essential functions listed on the Physical Conditions and Working Conditions charts referenced in the posting.

Responsibilities

• Assess and reassess patients, families, and relevant medical and psychosocial factors affecting the plan of care.
• Plan, organize, and coordinate care for assigned patients; document interventions accurately, appropriately, and on time.
• Communicate plans of care to the healthcare team through collaborative care rounds, concurrent documentation, and verbal communication.
• Evaluate and project discharge-planning needs and coordinate post-acute care, including referrals to skilled nursing facilities, personal care homes, home health, durable medical equipment, transportation, and community services.
• Review clinical criteria for ED and direct-admission patients to determine appropriate patient status and level of care, including inpatient, observation, outpatient testing or treatment, or an alternative level of care.
• Discuss level-of-care recommendations and care options with ED physicians, attending physicians, patients, and families.
• Apply InterQual Level of Care criteria for Severity of Illness and Intensity of Service indicators, and refer cases not meeting initial screens for second-level review.
• Coordinate authorization for admitted patients and patients transferred from the ED.
• Provide psychosocial assistance and emotional support to patients and families navigating the emergency room or hospitalization process.
• Provide limited therapeutic, goal-directed counseling to facilitate discharge planning.
• Connect patients and families with appropriate community services and serve as a resource on community resources and systems.
• Identify, track, and trend avoidable or delay days in the Midas system.
• Refer complex cases to the CRM Manager or designee and notify unit-based case managers of anticipated adverse determinations or complex psychosocial situations.
• Initiate contact with attending physicians when cases do not meet InterQual criteria; educate physicians and team members on criteria and appropriate alternatives to acute care.
• Collaborate with attending physicians and healthcare team members to facilitate progression of the plan of care and transitions to appropriate alternate care levels.
• Understand and communicate payor requirements and plan benefit limits or availability to patients or their representatives as necessary.
• Maintain accurate and timely documentation in recognized databases and maintain patient and program records in accordance with applicable standards and regulations.
• Provide case-management follow-through for the unit-based case manager when cases require follow-through after normal business hours.
• Attend appropriate meetings, meet regularly with the supervisor, and participate in continuing education.
• Maintain ethical conduct regarding confidentiality, dual relationships, and professional stature.
• Promote Lean principles and processes, seek work-process improvements, and take ownership of personal motivation, performance, morale, and professional development.
• Maintain regular, consistent, on-site, and timely attendance.
• Remotely monitor the bed board where applicable.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level