Social Worker Case Manager

Overview

• Join a dedicated healthcare team as a Social Worker Case Manager, providing essential care coordination and discharge planning services for patients in an acute care hospital setting.
• Perform initial comprehensive assessments to identify high-risk indicators and ensure appropriate supportive services for patient discharge and readmission prevention.
• Collaborate with multidisciplinary teams to deliver effective care coordination and transitional planning activities for diverse patient populations.
• Utilize established tools and protocols to assess patient needs and arrange aftercare services, including education and payer involvement.
• Contribute to department goals such as length-of-stay reduction, readmission prevention, and patient satisfaction improvement.
• Document patient care activities and reassessments in compliance with departmental requirements and standards.
• Participate in performance improvement initiatives to enhance patient care and operational efficiency.
• Work on-site with a schedule of Monday to Friday, 9 AM to 5 PM, including one weekend per month and alternate holidays.

Key Responsibilities & Duties

• Conduct initial patient assessments upon admission to identify discharge planning needs and high-risk indicators.
• Coordinate care across multidisciplinary teams, ensuring seamless intra-hospital and inter-hospital transitions.
• Develop and implement transitional plans, including patient education and arrangement of aftercare services.
• Collaborate with commercial payers to facilitate patient care and address high-utilizer patient root causes.
• Communicate relevant patient information to healthcare team members to support comprehensive care delivery.
• Document care activities and reassessments in compliance with departmental policies and standards.
• Participate in performance improvement initiatives to enhance patient outcomes and operational goals.
• Perform additional duties as assigned to support the Care Management Department's objectives.

Job Requirements

• Master of Social Work Degree from an accredited School of Social Work.
• Licensed Social Worker (LMSW/LCSW) approved by the State Education Department of New York.
• Two years of experience in an acute care hospital or related setting preferred.
• NYS SCREEN Certification required within the first three months of employment.
• Proficiency in discharge planning and care coordination processes.
• Strong documentation and communication skills to ensure compliance and effective collaboration.
• Ability to work on-site with a flexible schedule including weekends and holidays.
• Commitment to performance improvement and achieving departmental goals.