Sauk Prairie Healthcare
Case Manager - Social Worker (full-time) - Prairie Clinic
Prairie Clinic - Sauk City, WI · Full-time
Sponsorship not specifiedDetected 15 days ago
Patient CareCommunicationCollaborationProblem Solving
About the role
- This position serves as a patient advocate, as a resource to patients/families and staff, and as a leader of the interdisciplinary team continuity of care/discharge planning/aftercare planning/resources.
- The Case Manager-Social Worker conducts assessments of the biopsychosocial needs of patients, assists with identification of resources to assure successful outcomes, and facilitates expedited discharges across the continuum of care.
- Conduct concurrent medical record review using specific indicators and criteria as approved by medical staff, CMS, ACHC, and other state agencies.
Responsibilities
- Complete assessment of all patients referred or identified as having complex psychosocial concerns and/or as needing discharge planning services, including data related to home environment, support systems, community agency involvement and psychosocial concerns to determine post-hospital/clinic visit needs.
- Identify, assess, plan, implement, and evaluate individualized patient plan of care that includes clinic care, acute hospital care, discharge plan, transition to home or alternate site, and the use of community resources in conjunction with the multi-disciplinary care team, the patient and their family.
Nice to have
- Master's Degree in Social Work
- Two or more years' experience providing case management in a hospital or clinical setting.
- Clinical Social Worker (LCSW) License
- Advanced Practice Social Worker (CAPSW) Certification
- American Case Management Association (ACMA) Case Management certification
- Preferred: Master's Degree in Social Work
- Preferred: Two or more years' experience providing case management in a hospital or clinical setting.
- Preferred: Clinical Social Worker (LCSW) License
Benefits
- Competitive health and dental insurance options
- Flexible paid time off to balance work and life
- Retirement plan with vesting and employer match
- Work collaboratively with the care team and community agencies to assess, plan, and execute appropriate mental health and AODA services.
- Acts as patient advocate, investigates and reports adverse occurrences, and performs staff education related to resource utilization, SDOH, discharge planning, and psychosocial aspects of healthcare delivery.
- Address internal and external social, economic, emotional, medical, nursing and psychological needs, through referral, which will extend beyond the hospital/clinics
- Provide support to patients and families to improve their understanding of an adjustment to the diagnosis to maximize benefits of medical intervention and enhance patient and/or family functioning.
- Document accurate assessments and interventions in patient's electronic medical record in an effective and timely manner.
- Evaluate, plan, coordinate, review, and revise patient continuity of care/discharge plan/aftercare plan based on patient need in collaboration with medical staff and the multidisciplinary team.
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