Medical Social Worker - Utilization Review - Care Coordination

Overview

Presbyterian is seeking a Medical Social Worker to be part of the Case Management Team. Referrals for social work intervention require evaluation of needs to be met, understanding specific patient centered outcomes, and accountability of action within a case management team structure. Medical Social Workers assist with patient discharges from the hospital and coordinate care of patients with complex needs that require multiple services over time.as well as handling crisis intervention. The Medical Social Worker intervenes with patients who have complex psychosocial needs, require assistance with eligibility determination for social programs and funding sources and qualify for community assistance from a variety of special funds and agencies. In addition, offer crisis intervention to patients and families with psychosocial needs and coordinates and facilitates the development of a discharge plan of care for all patient populations. This role will receive referrals and consults for patients from at risk populations from interdisciplinary team members (including physicians, Case Managers, staff nurses and other members of the care team) in addition to case finding.

Sign on and relocation bonuses available for qualified candidates. 

 

How you grow, learn and thrive matters here. 

• Educational and career development options, including tuition and certification reimbursement, scholarship opportunities 

• Wearable alarm badge (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern) 

• Shift differentials for nights and weekends 

• Differentials for higher education, certifications and various lead roles 

• Malpractice liability insurance 

• Loan forgiveness through the New Mexico Higher Education Department  

• EPIC electronic charting system 

Type of Opportunity: Full Time FTE: 1.000000 Exempt: No Work Schedule: Days

Qualifications

Social Worker III

• Master’s degree in Social Work required.
• Current license from the State of New Mexico as a Licensed Independent Social Worker-LISW, Licensed Clinical Social Worker-LCSW, or Licensed Medical Social Work-LMSW.
• License with ten years hospital social work or discharge planning experience in relevant setting required.
• Licensed Medical Social Work License (LMSW) preferred.
• National Case Management certification preferredMaster’s degree in Social Work required.
• Current license from the State of New Mexico as a Licensed Independent Social Worker-LISW, Licensed Clinical Social Worker-LCSW, or Licensed Medical Social Work-LMSW.
• License with ten years hospital social work or discharge planning experience in relevant setting required.
• Licensed Medical Social Work License (LMSW) preferred.
• National Case Management certification preferred

Social Worker II

• Master’s degree in Social Work required.
• Current license from the State of New Mexico as a Licensed Independent Social Worker-LISW, Licensed Clinical Social Worker-LCSW, or Licensed Medical Social Work-LMSW.
• License with five years hospital social work or discharge planning experience in relevant setting required.
• One to two years hospital social work experience, protective services, or practicum in acute care settings experience desired.
• National Case Management certification preferred.

Social Worker I

• Master’s degree in Social Work required
• Current license from the State of New Mexico as a Licensed Independent Social Worker-LISW, Licensed Clinical Social Worker-LCSW, or Licensed Medical Social Work-LMSW.
• License with one to two years hospital social work or discharge planning experience in relevant setting required.
• One to two years hospital social work experience, protective services, or practicum in acute care settings experience desired.
• National Case Management certification preferred

Responsibilities

• On the basis of referral, consultation or case finding assesses patients and family s psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope.
• May provide initial screening in the ED for crisis intervention and overcapacity situations.
• Intervenes with patients and families regarding emotional, social, and financial consequences of illness and/or disability; accesses and mobilizes family/community resources to meet identified needs: Provides appropriate crisis management to patients and families.
• Provides support and counseling to patients / families experiencing and/or anticipating issues to adjusting to illness, catastrophic diagnosis, changes in living situations and bereavement.
• Provides intervention in cases involving child abuse/neglect, domestic violence, elderly abuse, institutional abuse and sexual assault.
• Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the health care system.
• Participates and arranges discharge planning activities for patients, to ensure a timely discharge and to provide appropriate linkage with post-acute providers.
• Works with families exhibiting complex family dynamics that impact directly on patient care and discharge.
• Works collaborates with the case manager and multidisciplinary team members regarding discharge planning and arranges for the appropriate level of care needed as determined by patients continuing clinical care needs.
• Educates patient/family and physician regarding post-acute options and addresses issues of choice.
• Actively participates and provides pertinent information in complex rounds discharge planning huddles, unit daily whiteboard rounds.
• Functions as the lead in assisting patients and families to obtain available financial and other resources including but not limited to Medicaid, SSDI, County Indigent Funds, UNM Cares, etc.
• Provides intervention in child abuse/neglect, domestic violence, guardianship (temporary/ permanent), foster care, adoption, mental health placement, advance directives, adult/elderly abuse, child protection and sexual assault.
•  Assists as indicated with end-of-life matters
•  Meets CMS Condition of Participation Requirements and applicable state and federal regulations.
• Serves as a lead in obtaining legal guardianship and competency determinations. Completes and disseminates all necessary legal in clinical documentation as required.
• Provides and updates community services resources, advice, and referral information.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization.
• Serves as preceptor, mentor, and resource to less experienced staff.
• Results of assessments, interventions and discharge planning are documented in the medical record according to departmental policies and procedures.
• Other duties as assigned.

Benefits

Benefits  

 

We're all about well-being, starting with yours. 

Presbyterian employees have access to a fun, engaging and unique wellness program, including free on-site and community-based gyms, nutrition coaching and classes, mindfulness and meditation resources, wellness challenges and more.    

 

Learn more about our employee benefits.   

 

Our culture is one of knowing and respecting our patients, members, and each other.  We capture this in our Promise and CARES commitments

 

About Presbyterian Healthcare Services 

 

Presbyterian exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system comprised of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 13,000 employees - including more than 1,200 providers and nearly 3,500 nurses.  

Our health plan serves more than 640,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.    

 

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. 

Maximum Offer for this position is up to

USD $38.86/Hr.

Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.