The Care Manager/Social Worker, as part of a multidisciplinary team, including the patient/family, physicians, nurse's therapists and payors ensures the patient's progress in the acute episode of care through post discharge and is quality driven while being efficient and cost effective. The incumbent interacts with patients, family members, healthcare professionals, and community and state agencies in this effort. The Care Manager/Social Worker serves as a liaison between the hospital and community agencies or facilities for the exchange of clinical and referral information. The Care Manager/Social Worker reviews high risk patients from a psychosocial and medical perspective and assesses the psychological needs of patients and families and provides information, support, counseling, care management, and referrals to appropriate resources. The LCSW Care Manager and RN Care Manager work collaboratively to ensure patient needs are met and care delivery is coordinated across the continuum. The expertise of the LCSW is sought to resolve psychosocial patient care issues and to develop complex patient transition/discharge plan as needed. The Care Manager/Social Worker is responsible for maintaining hospital compliance with the Quality Improvement Organization (QIO) series provides case review to third party payers and assisting in the denial and appeals process as well as assessing quality, levels of care and identifying and reporting potential risk management issues. The incumbent performs duties and tasks in accordance with performance standards established for the job. The incumbent may have access to highly confidential patient, employee and/or Mercy proprietary information, and must handle & protect the information in accordance with hospital & system policies, HIPAA requirements and the highest level of ethical standards. The incumbent is responsible for reporting all security events, potential events, or other security risks to the organization. The incumbent is responsible for participation in and completion of all patient safety initiatives appropriate to the position, and conducts all job responsibilities according to the Mission and Values of Northern Light Mercy Hospital.
Position requires licensure by the State of Maine Board of Social Work Licensure.
Licensed clinical social worker (LCSW). A Masters degree in Social Work is required. A minimum of two (2) years of clinical experience as Social Worker in an acute care setting is required. Experience in dealing with extended care facilities and community healthcare agencies is desired. A working knowledge of insurance coverage, various governmental programs, available community care agencies and long-term care facilities is preferred. Excellent interpersonal skills are required as the incumbent interacts with patients, families, physicians, and other caregivers within the hospital. Additionally, the incumbent has extensive interaction with a variety of care providers in the community, facilities and the government agencies. Must have excellent analytical and problem solving skills to assess patient discharge needs and evaluate applicability of available resources. Must have the judgment and initiative to operate independently and autonomously in the development, implementation and follow up of discharge plans with minimal guidance from the department manager. Must be highly accountable for timely and accurate planning and preparation to assure safe discharges and cost effective utilization of available resources for the continuation of patient care. The incumbent has access to highly confidential patient information. Knowledge of Social Work theories, therapies and techniques as used in individual family and group treatment.