Job Detail

Job Title:  Ambulatory Social Work Care Manager I-$5,000 Sign on Bonus

Department:  Ambulatory Care

Shift:  1st

Full/Part:  Active Regular FT (72 to 80 hours per pay period)

Specialty:  Social Work/Human Services

Job Number:  2023-2179

Job Description:

RUSH UNIVERSITY MEDICAL CENTER

JOB DESCRIPTION

TITLE: Social Work Care Manager LSW I

General Summary:

The Social Work Care Manager I is an Illinois licensed social worker who provides patient care through a diverse role as a clinician, educator, care coordinator and advocate. The SW CM I works in a collaborative relationship with other members of the health care team to facilitate effective care management and support services at the appropriate level of care, and implement sustainable solutions to support patients and families. The SW CM I incorporates a motivational interviewing approach, attending to the patient¡¦s ability to successfully self-manage chronic illnesses and effectively utilize health care services The individual who holds this position understands population management, exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures, including complying with all Rush University Medical Center Customer Service Standards.

Principal Duties and Responsibilities:

Utilize MHN portal and value based care EMR reports to identify patients in need of outreach efforts from a psychosocial and environmental perspective based on inter-professional team collaboration, clinic referrals, ER, and patient discharges.

Facilitate assessment of person's physiological, psychosocial, financial, cultural, and familial situation and coordination of psychosocial services to address person/family/caregiver needs. Develop a psychosocial plan of care and serve as a change agent to address the needs of patients with complex psychosocial issues.

Connect patient to needed community-based services, providing intensive care coordination as clinically indicated.

Confer, negotiate, advocate, and problem-solve with physician practice groups, community providers, patients, and the health care team regarding psychosocial issues, progression in plans of care, care transitions, and to improve patient access to needed services.

Align plan of care (current and anticipated) with available resources and proactively resolve barriers. Promote cost-effective quality care services.

Demonstrates ownership of the patient centered care plan, complex psychosocial issues and anticipated outcomes. Assess progress toward goals based on the clinician¡¦s assessment of the patients¡¦ cognitive and intellectual functioning, the patient¡¦s health beliefs and motivation, and strengths.

Participates in development, implementation and evaluation of programs within their respective RUMG clinics.

Provide crisis intervention when needed.

Provide educational materials and resources to patient and family that are in a format which is specific to the patient/family learning abilities and language preference.

Assist with timely follow-up and coordination of care for patients referred from the clinic, discharged from ER, hospital or other healthcare facility.

Identified care management contract outcomes (i.e. 7 day post inpatient discharge, Emergency Department visit follow-up, new patient outreach, ED frequent users) by using care management contract quality measures.

Collaborates as part of a multidisciplinary team. Respects each person¡¦s roles and contribution.

Models and maintains a quality based proactive patient centered approach to achieve department and institutional goals and process improvements.

CLINICAL RESPONSIBILITIES:

Interview, assess and evaluate patients, clients and families

Provide therapeutic and/or psychosocial interventions and treatment with the goal of maximizing personal/family stability relevant to the patient¡¦s clinical and discharge needs.

Prepare and document intake summaries, and develop treatment and discharge plans, in accordance with team recommendations and patient choice.

Document in accordance with regulatory guidelines to ensure effective communications, and to support reimbursement standards and requirements. Confer, collaborate and consult with treatment teams regarding patient progress, transition of care needs; make referrals and implement discharge plans.

Support quality improvement initiatives, including but not limited to data collection and reporting, chart reviews, interdisciplinary rounds. Attend relevant clinical meetings.

Perform related clinical duties as required.

ADMINISTRATIVE RESPONSIBILITIES:

Promote Social Work involvement in professional associations, by providing education and information related to SWCM certifications; support credentialing efforts for SW staff.

Organize and facilitate clinical supervision for social work staff. Manage, review and update staff continuing education needs. Attend individual and group supervision meetings for social workers for context in establishing social work trainings. Develop and provide trainings as needed.

Promote and provide education about the care management role throughout the organization. Identify and facilitate linkages for staff to professional development experiences.

Provide assistance with the MSW internship program as needed and directed by the MSW Internship Coordinator.

Review and revise job descriptions as relevant to contemporary practice, when directed by leadership.

Ensure CM policies and procedures are consistent with regulatory guidelines; provide updates to RUMC OP&P committees when indicated.

Support ICARE values. Model and encourage innovation and excellence. Promote outreach by staff to author abstracts, papers, posters for presentations internally and externally, with a focus on evidence based practice, in collaboration with CM leadership.

Knowledge, Skills and Abilities Required:

* Current license in Illinois as a Social Worker. LSW required.

* Master's Degree in Social Work from an accredited university

* Ability to perform all job components and serve as a team resource for clinically complex cases within their professional (social work) expertise.

* Experience related to psychosocial issues, crisis management, conflict resolution, person-centered planning and care transitions.

* Be willing to co-locate in the outpatient clinic when asked

* Process improvement skills, ability to perform tasks independently, prioritize workload, problem-solve, and analyze data.

* Experience utilizing motivational interviewing highly desirable

* Experience working with managed care in a health care setting highly desirable

* Strong active listening, critical thinking, judgment and decision making skills.

* Excellent verbal and written communication and organizational skills. Able to chart effectively in EPIC and use appropriate clinical social work terminology.

* Excellent interpersonal and team building skills, and ability to collaborate effectively with physicians, nurses, and other staff.

* Proficient and functional knowledge of Microsoft Office Suite, computer databases, electronic medical record systems, and info technology.

* Ability to function independently, to organize and be self-motivated

* Maintains professional growth and meets licensure/CEU requirements by attendance at various internal/external meetings, seminars, workshops. Willingness to present information to peers, team, etc.

Preferred:

* LCSW or commitment to obtain

* Case Management certification preferred (or commitment to obtain within 2.5 years)

* Bilingual English/Spanish highly desirable

Disclaimer:

The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

Rush University Medical Center is one of the country's leading medical centers pushing the boundaries of healthcare services with innovative, compassionate, and accountable team members. Are you ready to challenge and grow your skills, contribute to providing top-quality patient care, and enhance your career? Rush is a diverse and inclusive culture and offers a competitive salary, and a valuable compensation package including health, dental and vision benefits, retirement, health savings accounts, and tuition assistance to invest in your future.