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Case Manager Social Worker And/Or Case Manager Registered Nurse Full Time Days

Company Description

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

Job Description

1.0FTE

The Case Manager Social Worker reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Responsibilities:

  • Serves as primary liaison between the interdisciplinary team and the patient/caregiver, educates patient/caregiver on the continuum of care and facilitates discharge coordination.
  • Follows the patients from admission to discharge.
  • The case manager communicates to external payers on behalf of the patient.
  • Acts in partnership with the attending physician to closely monitor utilization and LOS.
  • Works with the patient/caregiver to plan and facilitate a timely and appropriate discharge plan.
  • Forwards assessments and clinical data to payers and external providers to facilitate transitions and payment
  • Handles caseload of patients as determined by manager
  • Communicates team conference and POC recommendations to patient and family and to third parties as indicated
  • Assists with facilitation of team conference to ensure that patient continues to meet LOC criteria and is progressing toward discharge goals in conjunction with interdisciplinary team.
  • Works with interdisciplinary team on ensuring procurement of discharge needs for patient in terms of DME, clinical services and ongoing care to support a safe transition to an appropriate LOC
  • Facilitates family training as needed in order to support a safe transition to the next LOC
  • Assesses need for and provides referrals to community resources to support the patient safely in the community setting
  • Coordinates with patient/financial services and admissions to ensure smooth transitions between levels of care and manage concurrent denials
  • Provides ongoing education to interdisciplinary team on patients insurance benefits and status of LOS approval
  • Requests authorization for continued stay from payers as recommended by interdisciplinary team through concurrent review process. Coordinates appeals on any concurrent denials of requests for continued stay.
  • Reviews patients progress and medical necessity for continued stay against protocol and benchmarks and communicates with attending physician and team
  • Monitors and communicates resource utilization with attending physician
  • Identifies variances from established benchmarks on cost/outcome/LOS and notify physician and team
  • Obtains authorization as required from payer for any special services or procedures
  • Case Managers in pediatrics assist with managing referrals for IRF and outpatient services as well as assists with referral development objectives
  • Case Managers in Pediatrics facilitate return to school after discharge and home/hospital tutoring

 

 

Qualifications

Social Worker

Required:

  • Master's Degree in Social Work with current LSW or LCSW license in the state of Illinois.

Preferred:

  • Previous experience with Case Management and/or Discharge Planning in a hospital setting
  • Previous experience in a rehabilitation setting

Registered Nurse:

Required:

Bachelor’s degree in Nursing with current RN license in the state of Illinois. OR
Master’s Degree in Social Work with current LSW or LCSW license in the state of Illinois.
 

Preferred:

Previous experience with Case Management and/or Discharge Planning in a hospital setting
Previous experience in a rehabilitation setting

Additional Information

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

Average salary estimate

$70000 / YEARLY (est.)
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$60000K
$80000K

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What You Should Know About Case Manager Social Worker And/Or Case Manager Registered Nurse Full Time Days, Northwestern Memorial Healthcare

Welcome to Northwestern Medicine, where being a Case Manager Social Worker or Case Manager Registered Nurse isn't just a job, it's a calling! You'll be at the heart of our mission, providing top-notch patient care while fostering valuable relationships between our diverse interdisciplinary team and the patients and caregivers we serve. With your expertise, you will guide patients through their healthcare journey from admission to discharge, ensuring they understand their care options and their path to recovery. Your role is crucial as you communicate with external payers, oversee resource utilization, and coordinate with various teams to facilitate safe transitions between care levels. Beyond managing your patient caseload, you will also contribute to the overall improvement of our healthcare system through ongoing education for the interdisciplinary team about insurance benefits and discharge planning. In joining us, you can take pride in working for a healthcare leader that values your input and encourages professional growth through generous benefits like tuition reimbursement and loan forgiveness. Whether you’re a Social Worker with a Master’s Degree and an LSW/LCSW license or a Registered Nurse with a Bachelor’s Degree and an RN license, your background and compassion will be essential in supporting our patients to thrive. Join us at our Wheaton location, and let’s make a difference together, one patient at a time!

Frequently Asked Questions (FAQs) for Case Manager Social Worker And/Or Case Manager Registered Nurse Full Time Days Role at Northwestern Memorial Healthcare
What qualities are essential for a Case Manager Social Worker at Northwestern Medicine?

A successful Case Manager Social Worker at Northwestern Medicine possesses strong communication skills, empathy, and an understanding of the healthcare landscape. They should have a Master's Degree in Social Work and either an LSW or LCSW license in Illinois. This role requires adept collaboration with interdisciplinary teams and a commitment to patient-centered care, aligning with Northwestern Medicine's values.

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What is the role of a Case Manager Registered Nurse at Northwestern Medicine?

At Northwestern Medicine, the Case Manager Registered Nurse plays a pivotal role in coordinating patient care from admission to discharge. They work closely with patients, caregivers, and healthcare teams to ensure effective communication and decision-making. This includes managing caseloads, comprehensively assessing patient needs, and facilitating discharge planning while advocating for the patient's best interests.

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How does the Case Manager Social Worker interact with patients at Northwestern Medicine?

The Case Manager Social Worker at Northwestern Medicine serves as a primary liaison between the interdisciplinary team and patients. They educate patients and caregivers on the continuum of care, facilitate discharge planning, and ensure patients receive the necessary resources for a safe transition. This hands-on approach is integral to maintaining patient satisfaction and optimizing health outcomes.

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What benefits does Northwestern Medicine offer for Case Manager roles?

Northwestern Medicine offers an impressive range of benefits for its Case Manager roles, including tuition reimbursement and loan forgiveness programs, 401(k) matching, and lifecycle benefits. These offerings not only support your financial well-being but also promote ongoing professional development, enabling you to thrive in your career as a Case Manager Social Worker or Registered Nurse.

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What qualifications are needed for the Case Manager roles at Northwestern Medicine?

To qualify for the Case Manager positions at Northwestern Medicine, candidates need either a Master's Degree in Social Work with a current LSW or LCSW license for Social Workers, or a Bachelor’s degree in Nursing with a current RN license for Registered Nurses. Previous experience in Case Management or Discharge Planning within a hospital or rehabilitation setting is preferred.

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How does Northwestern Medicine support the professional growth of Case Managers?

Northwestern Medicine actively supports the professional growth of its Case Managers through comprehensive training programs, mentorship opportunities, and access to resources that encourage continuous learning. This culture of development helps Case Managers excel in their roles and provide exceptional patient care while adapting to the ever-evolving healthcare landscape.

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What is the importance of teamwork in the Case Manager position at Northwestern Medicine?

Teamwork is crucial for Case Managers at Northwestern Medicine, as they collaborate with a wide range of healthcare professionals to offer holistic care. By working together with nurses, physicians, social workers, and external providers, Case Managers can efficiently manage patient caseloads, communicate effectively, and ensure seamless transitions in care, ultimately enhancing patient outcomes and satisfaction.

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Common Interview Questions for Case Manager Social Worker And/Or Case Manager Registered Nurse Full Time Days
How do you handle a complex patient case as a Case Manager?

When addressing a complex patient case, it's essential to first conduct a thorough assessment. This involves gathering all relevant medical history and potential barriers to care. I prioritize open communication with the interdisciplinary team to ensure everyone is on the same page, and I utilize critical thinking to create a comprehensive discharge plan that addresses the patient's specific needs.

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Can you describe your experience with discharge planning?

In my previous roles, I have actively participated in discharge planning by coordinating with various healthcare providers to ensure all necessary services are in place for the patient. I believe that understanding the patient's goals and preferences is key to a successful discharge, so I always involve them and their families in the conversation to ensure a smooth transition home.

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What methods do you use to educate patients about their care options?

I employ a patient-centered approach when educating patients about their care options. This includes simplifying complex medical information into digestible content, using visual aids, and engaging the patient in discussions to ensure they comprehend their choices. It’s also crucial to tailor the communication style to each individual, respecting their unique backgrounds and needs.

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How do you manage conflicts with external payers regarding patient coverage?

Managing conflicts with external payers requires a proactive approach. I maintain clear documentation of patient needs and continuously communicate with both the payer and the interdisciplinary team to advocate for the patient. If a conflict arises, I ensure to approach the situation calmly and professionally, focusing on finding common ground and pursuing a resolution that best serves the patient.

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What experience do you have working with interdisciplinary teams?

My experience with interdisciplinary teams has been deeply collaborative. I value each member's expertise and focus on fostering open communication. Regular team meetings allow us to discuss patient progress, share insights, and adjust care plans as necessary. I believe that appreciating everyone's input ultimately leads to better care outcomes for our patients.

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How do you stay current with changes in healthcare regulations?

I prioritize staying updated on healthcare regulations through continual education, attending workshops, and subscribing to professional journals. I also participate in relevant training sessions offered by my organization. This commitment to learning ensures that I can provide the best care while adhering to compliance and regulatory standards.

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Can you give an example of a successful discharge you facilitated?

One memorable case was a patient with multiple chronic conditions needing a tailored discharge plan. I collaborated with home health services to arrange follow-up care and ensured the patient received comprehensive education on their medications. The successful outcome and feedback from the patient and family reaffirmed the importance of teamwork in discharge planning.

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What strategies do you use to manage a heavy caseload?

To manage a heavy caseload effectively, I prioritize tasks by urgency and importance, utilizing a case management system for timely updates. I also believe in taking breaks to ensure a refreshed perspective. Delegating certain responsibilities to team members, when appropriate, helps maintain quality care while ensuring no patient feels overlooked.

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How do you foster relationships with patients and their families?

Building strong relationships with patients and families is vital in my approach. I establish trust by being approachable, actively listening to their concerns, and respecting their input in the care process. Regular check-ins and follow-ups help maintain this relationship throughout the patient's journey, ensuring they feel valued and supported.

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What do you consider the most rewarding aspect of being a Case Manager?

The most rewarding aspect of being a Case Manager is positively impacting a patient’s life during vulnerable times. Being able to witness patients progress towards recovery and knowing that I played a role in their journey makes the hard work worthwhile. Every success story reinforces my commitment to providing compassionate care.

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Northwestern Medicine is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine. The entities involved in Northwestern Medicine remain separate organizations. Northwestern Medicine is a t...

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Full-time, on-site
DATE POSTED
November 25, 2024

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