• Identify appropriate case management referral cases based on information collected from physicians, members of the health care team, families, review of the medical record and use of high-risk screening criteria. Perform detailed assessments of assigned cases that include Current health status of the patient including benefit coverage for all areas; Assessment of physical, psychological, and social needs of the patient; Identification of cultural influences on illness or injury; Identification of risks and hazardous home environments; and assessment of ability to perform activities of daily living and need for functional support.

• Understand concepts of utilization management and able to determine level of care status and whether the documentation by physicians and health care team supports the level of care. Collaborate with the physician and health care team on level of care concerns and documentation of variances.

• Identify barriers to high quality health care, such as the need for interpreter services and follow through with resolution.

• Demonstrate the ability to develop a plan of care that addresses needs across the continuum; have an intervention for each problem identified; develop long- and short-term goals with specific time frames for resolution; identify specific services to be provided in the care plan; include the family/care-giver in the plan of care; and show life planning contingencies such as power of attorney and/or advance directives.

• Establish relationships with key personnel both within and outside St. Mary’s Hospital to promote effective communication and fully support coordination of care linkages and resource management for the patient and family. Assists with developing departmental policies and procedures to support clinical resource management.

Qualifications:

• Master's degree in social work, Counseling, Nursing, or other health related programs.

• 1-2 years Full time clinical experience in individual, group, and family therapy.

• CM - Case Management Must be licensed or eligible in the State of Maryland.