Social Worker MSW - Ed

Independence Health System Careers•Greensburg, PA

1d•Onsite

About The Position

The Emergency Department Social Worker (ED SW) assesses, coordinates, facilitates, and negotiates services and resources for the ED population to support appropriate clinical and financial outcomes. The role reviews clinical criteria for ED and direct-admission patients, applies InterQual Level of Care criteria, and consults with physicians regarding the appropriate patient status, including acute inpatient admission, observation services, outpatient testing or treatment, or an alternate level of care. The ED SW coordinates discharge plans and post-ED care, including referrals for personal care, skilled nursing facility placement, home health, durable medical equipment, transportation, and community-based services. The ED SW supports patients and families through the emergency department and hospitalization process, provides emotional support and limited therapeutic, goal-directed counseling, and connects patients with community resources. The position collaborates with physicians and the healthcare team to coordinate care, authorization, utilization review, discharge planning, and follow-through on cases requiring attention after normal business hours. The role also documents interventions and patient records, monitors avoidable or delay days, supports denial management, and contributes to process improvement using Lean principles. Regular, consistent, on-site, and timely attendance is expected.

Requirements

Master’s degree in Social Work.
Three years of recent experience in Emergency Department, Utilization, or Case Management in healthcare.
Strong leadership ability.
Good organizational skills.
Independent and critical-thinking skills.
Sound judgment.
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.

Responsibilities

Assess and reassess patient, family, medical, and psychosocial factors affecting the plan of care for assigned patients.
Plan, organize, coordinate, and document patient care interventions accurately and promptly.
Communicate plans of care to healthcare team members through collaborative care rounds, concurrent documentation, and verbal communication.
Evaluate discharge 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 and recommend an appropriate level of care based on medical necessity criteria.
Discuss level-of-care recommendations and care options with ED and attending physicians, patients, and families.
Apply InterQual Level of Care criteria for Severity of Illness and Intensity of Service indicators; refer cases for second-level review when initial screens are not met.
Coordinate authorizations for admitted patients and patients transferred from the ED, and remain aware of payer requirements and benefit limits.
Collaborate with physicians and other healthcare team members to progress the plan of care and facilitate transition to an appropriate alternate level of care when indicated.
Assist patients and families in navigating the emergency department and hospitalization process, provide emotional support, and connect them with community services as appropriate.
Provide limited therapeutic, goal-directed counseling to patients and families to facilitate discharge planning.
Identify, track, and trend avoidable or delay days in the Midas system.
Refer complex cases to the CRM Manager or designee and notify the unit-based case manager of actual or anticipated adverse determinations or complex psychosocial situations.
Initiate contact with attending physicians regarding cases that do not meet InterQual criteria, clarify plans of care, and educate healthcare team members about criteria and appropriate alternatives to acute care.
Provide case-management follow-through for the unit-based case manager on cases requiring follow-through after normal business hours.
Maintain accurate and timely documentation in recognized databases and maintain patient and program records in accordance with applicable standards, regulations, and grant requirements.
Attend appropriate meetings, meet regularly with the supervisor, and participate in continuing education activities.
Maintain ethical conduct regarding confidentiality, professional boundaries, and professional stature.
Promote Lean principles and processes, seek work-process improvements, and take ownership of motivation, morale, performance, and professional development.
Maintain regular, consistent, on-site, and timely attendance.
Perform the essential functions described in the Physical Conditions and Working Conditions charts.