Job Category:

Behavioral Health, Counseling, and Clergy

Work Shift/Schedule:

8 Hr Morning - Afternoon

Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

About the Role:

Job Summary

The Case Management Social Worker is responsible for the provision of medical social work and case management services for patients receiving care in the hospital setting. Assesses the social, psychological, cultural, environmental, and financial situation, as well as disposition needs for patients. Collaborates with patients, families, healthcare team members, and community agencies to develop and implement plans to address identified needs. Evaluates effectiveness of plans and initiates change as needed. Uses crisis intervention, problem solving model, community organization, and advocacy skills in identifying needs and resources in the hospital and community. This position will come in contact with patients in the neonate, infant, child, adolescent, adult, and geriatric age groups; Employees will perform clinical duties in accordance with population specific guidelines and adhere to National Patient Safety Guidelines. Provides cross coverage for all Social Workers as required across all settings in the care continuum, including weekend rotation (as needed).

Minimum Job Qualifications

• Licensure or other certifications: CCM (Case Management Certification) or ACM (American Case Management Certification) required within three (3) years of date of hire.
• Educational Requirements: Masters Degree in Social Work from an accredited School of Social Work; licensure preferred. Eligibility requirements for certification: 12 months full-time case management experience supervised by a certified case manager, or 24 months full-time case management experience not supervised by a certified case manager.
• Minimum Experience: Demonstrates the minimum knowledge, skills, and abilities to care for the individualized needs of the patient to include physical, psychological, sociocultural, spiritual and cognitive needs as well as functional abilities including the need for diversified use of such practices.
• Other:

Preferred Job Qualifications

• Preferred Licensure or other certifications:
• Preferred Educational Requirements:
• Preferred Experience: A minimum of one (1) year experience in a hospital preferred, agency or institution providing related health care services.
• Other:

Job Specific and Unique Knowledge, Skills and Abilities

• Excellent communication skills. Exhibit a positive attitude.
• Social Work assessment and counseling skills.
• Knowledge of state and federal programs that provide medical care and financial support to individuals.
• Knowledge of community resources.
• Ability to work with diverse patient and staff populations.
• Ability to work independently and amicably in group situations
• Conversant with current thinking on professional conduct and practice.
• Must have strong clinical assessment, intervention, and counseling skills across all age ranges; child, adolescent and adult.
• Ability to work with individuals of varying cultural and socio-economic backgrounds
• Knowledge of Long Term Care regulations, financial eligibility and admission criteria.
• Knowledge of adoption and surrogacy policies and regulations.
• Demonstrates the ability to think 'outside of the box' and consistently create new, and effective solutions to today's problems and opportunities.

Essential Tasks and Responsibilities

• Monitor all patients on assigned units to ensure appropriate use of resources and interventions while managing patient's length of stay based on working DRG/admitting diagnosis.
• Communicates with Physician, patient/family, and other disciplines the expected length of stay, along with patient progress towards discharge.
• Provides coordination and facilitation oversight of patient care to assure required interventions occur in proper sequence and processes occur in a timely manner without delays. Identifies and acts upon potential delays in services; escalates unresolved delays to management for appropriate intervention.
• Assess, coordinate and facilitate patient's discharge plan to assure post-acute needs are arranged and secured prior to discharge; Communicate discharge plan with Physician, patient/family, and other members of the healthcare team as appropriate; Reassess discharge plan routinely throughout patient's stay to ensure timely, safe discharge and appropriate transition to the next level of care. Provides patient/family with information regarding their plan of care, discharge and any financial responsibility of inpatient or post-hospitalization services.
• Maintain knowledge of reimbursement methodologies and general coverage guidelines for all levels of inpatient and outpatient care. Communicate with Physician, patient/family or other team members as needed to ensure services will be covered.
• Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients are in the right status and level of care. Facilitate changes by communicating with Physician, mid-level or nursing staff as needed.
• Serve as liaison to patients family, Physicians, nursing staff and all other disciplines to achieve optimal outcomes in the development of patient's discharge plan. Serve as a leader on assigned unit in the areas of discharge planning, social service issues, community resources/referrals and financial information related to patient care and outcomes. Empowered to think outside of the box to consistently create new, and effective solutions to complex problems or opportunities.
• Actively supports a customer service oriented environment to continually enhance customer service; Communicates directly with Physicians, nursing staff, patient/family and other disciplines to ensure collaborative practice. Provide appropriate hand-off communication as patients transition from one unit to another to ensure and achieve optimal outcomes.
• Maintains positive attitude, and communicates appropriately with patients/families, Physician, management and other staff; responds positively to change and offers suggestions to effectively incorporate change as needed in daily workflow.
• Maintain detailed knowledge of community resources, governmental regulations, third party payers (PPO/HMO's) to facilitate appropriate outcomes.
• Adheres to all regulatory and DNV requirements; Knowledgeable of third party/governmental payer regulatory requirements and adheres to appropriate processes. Completes paperwork as required.
• Consistently demonstrates a 'sense of urgency' in his/her work, while mindful of the pillars and financial stewardship opportunities.
• Works all scheduled shifts, including weekend rotation, and remote coverage.
• Responds to calls/referrals/consults within 24 hours. Communicates in a respectful manner.  Responds to calls with appropriate resources or manages the call in a satisfactory manner.  Contacts supervisor and other resources for assistance when needed.  Completes all documentation related to actions taken.
• Case Manager, RN-Social Work Consults. RN Case Managers and SW Case Managers will work in collaboration to ensure patients are assigned based on discipline-specific knowledge and expertise. Social workers will assume responsibility for patients with complex social needs such as: indigent, behavioral issues, complex family dynamics, unidentified patients, and abuse and neglect. RNs will maintain oversight for all plans of care and assume direct responsibility for medically complex patients such as: complex wounds, IV medications, enteral feedings, and other complex DME.

Physical Demands

• Weight Lifted: Up to 50 lbs, Occasionally 0-30% of time
• Weight Carried: Up to 50 lbs, Occasionally 0-30% of time
• Vision: Moderate, Frequently 31-65% of time
• Kneeling/Stooping/Bending: Occasionally 0-30%
• Standing/Walking: Occasionally 0-30%
• Pushing/Pulling: Occasionally 0-30%
• Intensity of Work: Constantly 66-100%
• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals. 

NGHS: Opportunities start here.

Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.