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Nurse Case Manager/Social Worker

The Nurse Case Manager utilizes clinical expertise and critical thinking skills to develop and implement a plan of care that provides cost effective, extraordinary care. This position works collaboratively with patients, patient families/significant others, healthcare providers, insurers, community resources, and other involved parties.

The Clinical Social Worker utilizes clinical expertise to perform psychosocial assessments, develop and implement plans of care appropriate care team, assess crisis situations to appropriately provide needed resources and or referrals for the patient, and to provide family and individual treatment as indicated. This position works collaboratively with patients, patient's significant other, families, healthcare providers, insurers, community resources, and all other involved parties.

Job Essentials

Nurse Case Manager

Organizes and prioritizes daily work by assessing new, current, and discharging patient needs in area(s) of responsibility. Completes documentation as required.
Performs utilization review activities to provide patient appropriate, timely, and cost effective care. Coordinates care with patient, care providers, hospital financial services, and third-party payers.
Maintains an active role in denial prevention. Proactively intervenes with payers to prevent inpatient denials. Performs retroactive reviews on discharged patients as assigned. Communicates any necessary information to payers to help appeal existing denials. Uses level of care criteria to justify the patient's severity of illness and intensity of service. Reviews payer requirements and government regulations to ensure safe and cost-effective healthcare.
Screens and coordinates the discharge planning process from patient admission to departure. Assesses patient needs, develops a discharge plan, and coordinates with internal and external services for care during and after the hospital stay
Identifies patients with potential avoidable delays, extended stay, readmission, or discharge needs. Coordinates with care providers and leaders to reach optimal solutions.
Educates, communicates, and coordinates with multiple patient care teams to ensure the patient receives quality care, a timely discharge, and to identify and resolve delays and issues.


Social Worker

Assesses the patient's medical history, mental health history, and current presentation to understand the patient's needs from treatment. Organizes and prioritizes daily work by assessing new, current, and discharging patient needs in area(s) of responsibility. Diagnoses and treats various mental, emotional, and behavioral disorders. Performs social work consultation for patients and caregivers. Conducts psychoscial assessments. Provides supportive, crisis bereavement and other social work interventions as necessary. Develops a plan of care either individually or with input from the patient, patient family and significant others, physicians, and other members of the healthcare team. Modifies care plans to reflect changes in patient status. Refers patients to other services to improve their well-being. These referrals may include community services, treatment programs, support groups, psychiatrists, or other mental health providers. Educates, communicates, and coordinates with multiple patient care teams and outside agencies as necessary to ensure the patient receives quality care, a timely discharge, and to identify and resolve delays and issues. Credentialing through medical staff office and peer review requirements may apply if working in the behavioral health setting. May provide support and debriefing, in conjunction with the Employee Assistance Program, for staff members following adverse events. Acts as an advocate on behalf of patients and families, where appropriate, to ensure effective communication with multidisciplinary care team, outside agencies and other resources as necessary. Works with the multi-disciplinary team to develop a discharge plan in order to provide further care, services, and referrals in order to ensure continuity of care. Completes timely and accurate documentation in the medical record using knowledge of documentation standards for the department to facilitate communication with team members. Documentation is done in compliance with all clinical guidelines and billing/reimbursement standards. Complies with federal, state, local, and clinical program/facility standards. Acts within the scope of the Mental Health Practice Act. May identify patients at risk for potential avoidable delays, extended stay, readmission, financial or complex discharge needs. Coordinate with care providers and leaders to reach optimal solutions.

Job Specifics

  • Benefits Eligible: Yes; Medical, Dental, Vision, Education Assistance. Click here for more details
  • Shift Details: Full Time - 40hrs/wk. Exempt. Shifts: Monday-Friday, 8:30A-5:00P.
  • Department/Unit: Hospital Care Management. We are accepting applications for Nurse Care Manager and Social Worker- Clinical.

 

Minimum Qualifications

Nurse Case Manager

Bachelor's degree in Nursing (BSN). Education must be obtained from an accredited institution. Degree will be verified.

Current RN license for state in which the nurse practices.

Three years of clinical nursing experience.
- and -
Basic computer skills and knowledge of word processing software.

Social Worker

Master's Degree in Social Work. Education must be obtained from an accredited institution. Degree will be verified.

Current State Licensure as LCSW or CSW.

Computer Skills, i.e., email, word processing. - and - Excellent written and verbal communication skills.

Preferred Qualifications Experience with patients, families, and treatment teams.

Preferred Qualifications

Nurse Case Manager

Case management Certification.
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experience in Case management, Utilization review, and/or discharge planning.

Experience in Case management, Utilization review, and/or discharge planning.

Social Worker

Experience with patients, families, and treatment teams.

Physical Requirements:

Ongoing need for employee to see and read information, labels, monitors, identify equipment and supplies, and be able to assess patient needs.
- and -
Frequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.
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Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information, etc.

For more information or to apply, visit https://imh.wd5.myworkdayjobs.com/IntermountainCareers/job/LDS-Hospital/Nurse-Case-Manager_R37490

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Last Updated: 7/14/22