Pool Case Manager (Variable Shifts)
Follows patient’s care from pre-admission screening, through hospitalization, to post-discharge follow-up with emphasis on collaborative relationships with patients and families, clinical nurses, physicians, social workers and other health team members to best meet the patient’s physical, emotional, and spiritual needs. Assists patients and families in coping with problems resulting from severe or long-term illness, and with difficulties in recovery and rehabilitation. In doing so, interviews patients and families to obtain psycho-social history, assists patients in resolving environmental difficulties interfering with attainment of maximum benefits from medical care and conducts routine discharge planning. Prepares and updates social work case records including nature of social problems, patient and family progress, and treatment administered. Directs patients to designated community agencies or resources, as necessary. Specifically, the Case Manager uses a problem solving process that includes assessment, problem identification, goal definition, plan development, evaluation and revision of the plan to achieve optimum patient outcomes.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Consistently supports the hospital’s Spirit of Serving Standards, in line with the Mission, Vision and values of St. Joseph Medical Center.
- Follows the guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).
- Promotes a culture of safety for patients and Associates through proper identification, proper reporting, documentation and prevention of medical errors in a non-punitive environment.
- Demonstrates leadership skills including recognition and acceptance of accountability and responsibility for duties and functions in collaboration with other team members towards problem resolution and is precise and appropriate in verbal and written communication.
- Performs concurrent reviews of admissions to determine medical necessity for admission, and continued stays. Refers those that do not meet criteria to departmental management.
- Maintains a regular caseload of more difficult and/or complex patient care problems. In doing so, contacts and interview patients and families to assess and evaluate patient’s social, financial and environmental situations. Reviews patient information obtained from patient care staff or medical records to determine patient’s needs. Interviews patients and families to obtain psychosocial history.
- Completes psychosocial assessments, individual, family, and/or group therapy sessions with patients admitted to acute inpatient psychiatric care. This accounts for a minimum of five hours weekly.
- Communicates with physicians and collaborates with other members of the health care team. Obtains necessary medical, nursing and other staff insights from appropriate hospital personnel and/or medical records to assist in determining and meeting patient needs; communicates with other patient care team members exchanging information regarding social, emotional or environmental problems which may affect patient’s response to treatment and/or discharge plans.
- Conducts ongoing utilization reviews for compliance with approved third-party treatment plan and ensures necessary interventions. Communicates with payors regarding clinical updates and the need for continued hospitalization.
- Prepares and updates records including nature of social problems, patient and family progress, and steps taken; may include pertinent summaries or notes containing related social information of use to patient care personnel. Maintains appropriate casework statistics. Directs patients to designated community agencies or resources for financial assistance, counseling, auxiliary care and so forth.
- Assesses each patient for discharge planning and educational needs, plans and patient’s care and ensures the patient family teaching is complete, related to discharge planning.
- Supportive of the compliance program set forth by IASIS and demonstrated by:
- Upholds the Standards of Conduct and Corporate Compliance.
- Adheres to and helps to enforce all compliance policies relevant to his/her area.
- Assures timely compliance education as requested by the Regional Compliance & Safety Officer and/or through corporate initiatives.
- Sets an example to all staff in their daily activities.
MINIMUM KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
- Approximately six to twelve months on the job experience necessary in order to gain full knowledge of federal, state and local regulations related to discharge planning and knowledge of health and welfare resources and facilities.
- Current state license as a Social Worker, LPC or R.N.
- Extensive work experience can be substituted for licensure
- Current American Heart Association Basic Life Support Certification is required.
EDUCATION & TRAINING:
- Knowledge of social work theories, therapies and techniques of casework processes, and principles of public welfare at a level normally acquired through completion of a Master’s degree in Social Work with course work in Medical Social Work preferred from an accredited Graduate School of Social Work. Work experience can be substituted for licensure.
- Interpersonal skills necessary in order to obtain information from patients and families, provide counseling to same and interact effectively with patients, families and hospital patient care personnel.
- Analytical skills necessary in order to assess patient’s needs, develop associated discharge planning and provide sound advice and guidance.
- Ability to concentrate and pay close attention to detail for up to fifty percent of work time when interviewing patients, providing therapy, preparing discharge plans and the like.
- Able to communicate effectively, in English, both verbally and in writing.
- Additional languages preferred.
- Basic computer knowledge.
For physical demands of position, including vision, hearing, repetitive motion and environment, see following description. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising client care.