Social Worker - Case Management
About The Position
The Social Worker facilitates care across the continuum through effective resource coordination, helping patients achieve optimal health, access care, and use resources appropriately while respecting their resources and right to self-determination. The role ensures care is provided at the appropriate level based on medical necessity and assesses transition needs to promote timely throughput, safe discharge, and prevention of avoidable readmissions. It also conducts complex psychosocial assessments and interventions. The position integrates national case management standards, including transition management, care coordination, compliance with regulatory and accreditation requirements, and education for physicians, patients, families, caregivers, and staff. It participates in planning social work components for selected hospital programs and collaborates with community providers to develop educational resources. Responsibilities include care coordination; transition planning assessment and reassessment; implementation or oversight of transition and discharge plans; assistance with adoption, abuse, and neglect cases; facilitating multidisciplinary patient care conferences; making referrals; communicating care plans to patients and families; collaborating with physicians and hospital departments; supporting patient education for post-acute needs; maintaining timely documentation and accurate demographic and insurance information; precepting and supporting staff; facilitating TEMPO as needed; and participating in quality improvement initiatives.
Requirements
- Master of Social Work (MSW).
- Demonstrated organizational skills.
- Excellent verbal and written communication skills.
- Ability to lead and coordinate activities of a diverse group in a fast-paced environment.
- Critical-thinking and problem-solving skills.
- Computer literacy.
Nice To Haves
- Minimum of two years of acute hospital experience preferred.
Responsibilities
- Coordinate care and ensure it is sequenced and provided at the appropriate level of care.
- Assess and reassess transition needs, including conducting complex psychosocial assessments and interventions.
- Implement or oversee implementation of transition and discharge plans to support safe discharge, timely throughput, and readmission prevention.
- Assist with adoption, abuse, and neglect cases through assessment, intervention, and referral to appropriate local, state, or federal agencies.
- Lead or facilitate multidisciplinary patient care conferences, including Complex Case Review.
- Make appropriate referrals to other departments.
- Communicate the plan of care to patients and families.
- Collaborate with physicians, office staff, ancillary departments, and community providers.
- Ensure patient education is completed to support post-acute needs.
- Complete timely, accurate, and concise documentation in the Case Management system and maintain accurate patient demographic and insurance information.
- Precept new staff members and act as a resource to staff.
- Facilitate TEMPO as needed.
- Participate in department quality improvement initiatives.
- Participate in planning the social work component of selected hospital programs.
- Provide in-service education for staff and education for physicians, patients, families, and caregivers.
- Perform other duties as assigned.
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- Life insurance
- 401(k) retirement savings plan with employer match
- Paid time off
- Career development and continuing education opportunities
- Health savings accounts
- Healthcare and dependent flexible spending accounts
- Employee Assistance Program
- Employee discount program
- Voluntary pet insurance
- Voluntary legal insurance
- Voluntary accident and critical illness insurance
- Voluntary long-term care insurance
- Voluntary elder and childcare benefits
- Voluntary auto and home insurance
