Social work case manager job description

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region. The fully integrated network is comprised of PIH Health Hospital - Whittier, PIH Health Hospital - Downey and PIH Health Good Samaritan Hospital, 27 outpatient medical locations, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, women's health, urgent care and emergency services.

The MSW interviews and evaluates patients and family members to identify social, emotional and economic factors which may interfere with obtaining maximum benefits from medical care; develops and implements a social work treatment plan to be offered to patients and family; selects and utilizes community resources as part of the treatment plan; makes referrals to and coordinates with other professional disciplines or agencies; provides psycho-social therapy using a variety of treatment methods; participates in multidisciplinary health team conferences to formulate the overall patient care plans by interpreting to the team the psycho-social aspects of the patient's illness; assists in the coordination of the discharge plan
Required Skills



Demonstrated skill in patient assessment, planning, intervention and evaluation.
Strong communication skills, verbal, non-verbal, written and oral.
Familiarity with regulatory agency requirements, policies and protocols.



Required Experience

Master's Degree from an Accredited School of Social Work.
Registered as an Associate Clinical Social Worker issued by the California Board of Behavioral Science
strongly preferred.
Evidence of continuing education.
Prior experience in a healthcare setting preferred.
Familiarity with regulatory requirements related to reporting of child/elder abuse, substance use/abuse, child protective custody, adoptions, and other legal requirements.



Certification:



Current Basic Life Support (BLS) card from American Heart Association.
LA City fire card within 6 months of employment



The organization is recognized by Watson Health as one of the nation's Top Hospitals, and College of Healthcare Information Management Executives (CHIME) as one of the nation's top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology. PIH Health is certified as a Great Place to Work TM . For more information, visit PIHHealth.org or follow us on Facebook, Twitter, or Instagram.

As a Social Worker Case Manager l, you will provide/evaluate biopsychosocial impact on patients' plans of care. To help achieve our mission, you will evaluate the ability of patients to progress throughout the continuum of care. Working collaboratively in communication with physicians, nursing and other members of the multidisciplinary care team to effect timely and appropriate patient management is of vital importance. Showcasing a working knowledge/experience in utilization management, managed care and payer issues is essential. Providing discharge planning and continuity of care for assigned patients in the acute and post-acute setting, with an understanding of pre/post-acute resources, is required. Your ability to provide coordination of services and act as a key Liaison between patients, families and the interdisciplinary healthcare members is expected.
Job Responsibilities

* Participates in the assessment of patients' biopsychosocial needs through review of patient information, personal contact with patients/families and interdisciplinary care team members.
* Communicates routinely with patients, families, interdisciplinary care team members and other appropriate parties with regard to the status of patients' care plans. progress toward treatment goals, identification of concerns and/or problems, problem solving and assisting with conflict resolution when necessary.
* Ensures that all options available to support a successful transition and elements critical to patients' care plans have been communicated to patients/families and members of the healthcare team and are documented as necessary to ensure continuity of care.
* Demonstrates a working knowledge of and experience in utilization management, managed care and payer issues.
* Understands utilization management and the use of clinical milestones to define transition timelines and community resources.
* Understands post-acute care criteria and documents appropriate referrals based on patients' clinical presentation and education needs.
* Refers cases and issues appropriately to resolve barriers to care progression.
* On the basis of preliminary risk screenings, assesses the psychosocial risk factors of patients/families through the evaluation of prior functional levels, appropriateness/adequacy of support systems, reactions to illnesses and the ability to cope.
* Intervenes with patients/families regarding emotional, social and financial consequences of illness and/or disability.
* Serves as a resource person and provides counseling and interventions related to treatment and end of life decisions.
* Advocates for patient/family empowerment and independence to make autonomous healthcare decisions and access needed healthcare services.
* Provides discharge planning and continuity of care for assigned patients in the acute and post-acute settings.
* Initiates and facilitates referrals to clinics, home healthcare, hospice, SNF, acute rehab, LTAC, TCM, medical equipment and supplies as indicated.
* Collaborates with the interdisciplinary care team, patients and families in the assessment/coordination of discharge planning needs, delivery of post-discharge planning needs, delivery of post-discharge services and transition of patients from the hospital to the discharge setting as well as ongoing care in the community.
* Documents relevant discharge planning information in the medical record according to department standards and/or care management plans.
* Collaborates/communicates with internal/external Case Managers.
* Understands pre/post-acute resources. Provides coordination of services and acts as a key Liaison between patients, families and the interdisciplinary healthcare members.
* Works holistically to ensure that care/discharge plans meet the physical, social and emotional needs of patients.
* Acts as an advocate for patients to resolve barriers to care progression.

Requirements

Education: MSW

Experience: 1 year of case management or clinical experience

Certification: BLS through the American Heart Association

Monitors and manages patient care to promote continuity of care, optimal patient outcomes, patient satisfaction, cost efficiency, and compliance.

Consults with nursing staff and multidisciplinary team regularly to evaluate patient's status andappropriateness of medical care, including admission, length of stay, transfer and discharge.

Case Management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective outcomes.The case manager conducts a comprehensive assessment of the client's health needs to develop a plan of care.The case manager plans with the patient, attending physician, the primary care physician's office, other health care providers, the payer, and the community to maximize health care response and quality, cost-effective outcomes.Case Managers are responsible for providing education to patient and or family members regarding their disease process and their comorbid diagnosis.Case Managers will complete the Utilization Review through InterQual or a similar module to assure patients are in the appropriate level of care.

Participates in discharge planning including coordinating patient transfers to other facilities and coordinating community resources. Provides discharge education and resource referrals to patients.

Every effort has been made to make this job description as complete as possible. However, it in no way states or implies that these are the only duties the incumbent will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is a logical assignment to the position. This position description does not restrict the right of management to assign or reassign duties and responsibilities with and without notice To perform this job, an individual must perform each essential function satisfactorily with or without a reasonable accommodation.
*Minimum Education*

High school diploma or equivalent □ Preferred X Required

X Associate's degree □ Preferred X Required

X Bachelor's degree X Preferred □ Required

*Required Skills*

Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.

*Certifications:*

Basic Life Support (BLS) - American Heart Association X Required at time of hire Any other certifications are acceptable and welcomed.If employee has ACLS (American Heart) BLS is not required.X Must be willing to sit for and obtain a certification within case management that is appropriate based on their professional licensure

*Minimum Work Experience*

Minimum of 3-5 years in Case Management/Utilization Review X Preferred

*Required Licenses*

[Arizona, United States] Social Worker
Active MSW Licensure in good standing

**Job:** **Case Management/Social Services*

**Organization:** **Valley View Medical Center*

**Title:** *Case Manager, Social Worker*

**Location:** *Arizona-Ft. Mohave*