Case Manager - Social Worker

SUMMARY:

Partners with a multi-disciplinary team to coordinate a plan of care utilizing expertise in counseling, crisis intervention and medical-legal issues, to ensure optimization of health outcomes for patients and their families.  

ESSENTIAL FUNCTIONS:

Assesses, documents, and addresses psychosocial, cultural, emotional, and economic needs of patients and families during the hospitalization and discharge planning process.

Collaborates with the hospital care team, outpatient care team, and community agencies as needed, to creatively resolve issues that could prevent safe and timely patient discharges.

Ensures documentation in the electronic medical record is clear, concise and organized.

Assesses, intervenes, and acts as a resource in medical-legal situations for patients and families.

Identifies community resources and programs appropriate for patients and families.

Develops treatment plans and discusses proposed course of treatment with patient’s primary physician.

Provides follow up on open issues to ensure patient/family /staff concerns are appropriately resolved in a timely manner.

Assists patients and families in making difficult decisions, while honoring their preferences and values, in order to move the discharge plan forward.

Evaluates case management processes to initiate changes when indicated to ensure efficiency and maximize benefit to patient and organization.

Intervenes, as needed, in emotional crisis situations with patients and families.

Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION:  Masters in Social Work or equivalent required.

EXPERIENCE: One (1) year of related social work experience.

LICENSURE OR CERTIFICATION: HeartSaver First Aid CPR Certification or Basic Life Support (BLS) Certification.