What are the responsibilities and job description for the Social Worker/Case Manager position at HAWARDEN REGIONAL HEALTHCARE?
Job Details
Description
GENERAL SUMMARY:
The Social Worker/Case Manager is responsible for the appropriate use of patient services, through evaluation of admission, use of ancillary services, and/or length of hospital stay. Responsible for assessing, coordinating, and implementing the discharge needs of the patient and assesses the physical, intellectual, emotional, social, financial, and spiritual needs of the patient and family. Successful completion of this function will result in patients receiving the appropriate level of care and appropriate discharge planning. Adheres to the values and mission of Hawarden Regional Hospital in all aspects of job performance.
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ESSENTIAL JOB FUNCTIONAL COMPETENCIES: |
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Demonstrates the knowledge and skills necessary to provide service/care appropriate to the age of the patients served, in accordance with Hawarden Regional Healthcare standards. Maintains a working knowledge of applicable Federal, State and local laws and regulations, the Compliance Accountability Program, Code of Ethics, and HRH policies and procedures, including all provisions of the Health Insurance Portability Act of 1996 (HIPAA). In order to ensure adherence in a manner that reflects honest, ethical and professional behavior by implementing the organizational vision, values, and mission. |
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Skilled in doing comprehensive evaluations and assessments |
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Strong social and cooperative skills in dealing with team members and other staff. |
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Interview patient and family members to obtain information about home environment, family relationships, health history and patients personality traits. Complete discharge plan in medical record. |
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Evaluate data gathered in terms of the medical plan of treatment, available social service programs and plan of pertinent therapy program that will provide maximum benefits and education for each patient. Evaluate patient for financial barriers, i.e. self-pay, and provide with information on available resources. Assist patient with completion of Title XIX application and/or self- pay application. |
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Assist patients and families to coordinate care, assist with education and provide guidance on medical recommendations. |
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Facilitates and coordinates placement of swing bed patients to the hospital. |
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Perform a variety of services such as advising on social problems, will assist Director of Patient Care service and physician with discharge arrangements, multidisciplinary rounding (MDR), placement of patients to home, and assisted living or nursing homes and alleviation of anxieties and fears. |
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Assist patients with Advanced Care Planning and formulation of Advanced Directives |
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Evaluate patients for DME, home health needs, nutrition needs, transportation needs, and complete referrals as indicated. |
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Prepare and update records for each patient. Prepare required documentation of each case. Maintain records, reports, etc. as required. Prepares and completed the psychosocial assessments on all Skilled Swing Bed patients within two (2) business days after admission. |
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Coordinate and facilitate with the Director of Patient Services Care Conferences on a weekly basis. Evaluates ongoing progress and treatment plan to re-assess needs and update discharge plan. Document outcomes on Multidisciplinary team note and inform the physician of outcomes. |
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Ensures compliance with discharge planning standards as defined by regulatory and accrediting agencies. |
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Social Worker/Case Manager coordinates and makes referrals to various agencies as needed based on the patient’s plan of care. Advocates for or assists patient in obtaining needed community services/resources. |
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Knowledge of principles and practices of social work and case management techniques used, including federal regulations and state laws. Has knowledge of current information pertaining to the symptoms, control, treatment, and effects of substance abuse, mental illness and family dynamics in families dealing with chronic illness. Had advanced interviewing skills. |
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Evaluates insurance data, denials, and quality issues to identify areas of concern and enhance effectiveness of service. Ensures proper notices & reviews are completed for Medicare, OBS and Swingbed admissions. |
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Encourages/facilitates physician response to insurance denials and quality issues. |
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Cooperates with other departments to ensure that the hospital receives maximum reimbursement for its services. |
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Assist with meeting guidelines according to Medicare, Medicare Advantage Plans, & Medicaid including assisting with denials and non-coverage notices as necessary. |
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Keeps physicians and staff informed of current insurance or government decisions, rulings, and changes. |
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Participates in special projects, committees, short and long range planning. |
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Facilitates utilization review requirements and assists nursing staff in maintaining basic knowledge. |
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Keeps up to date on new procedures and research. Maintains confidentiality of information pertaining to clients, practitioners, employees and HRH business. |
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Assists with swingbed referral review and prior authorization completion. |
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Completes all mandatory training such as Healthstream, The Patient Experience, Safe Choices, Crucial Conversations and any other training as designated by Administration. |
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Performs other duties and responsibilities as assigned. |
The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.
MISSION STATEMENT
Provide for the health and wellness of all in our communities through delivery of quality healthcare services close to home.
STANDARDS OF EXCELLENCE
The standards of excellence are the behaviors necessary for all of us to achieve our Vision. They are:
- Trust – Being a reliable resource for patients, families and co-workers by acting with honesty and integrity at all times.
- Caring – Displaying kindness and concern for others by creating a welcoming environment for all those who enter our facility.
- Communication – Giving and receiving information that others need or desire.
- Pride – Fulfillment of being a part of something bigger than yourself.
- Accountability – Taking responsibility for my actions and decisions.
- Respect – Honoring our patients, families and co-workers.
COMMITMENT
Must be able to embrace and adhere to the standards of excellence of the organization and support the Mission of Hawarden Regional Healthcare.
Must demonstrate good work habits such as time management, attendance, punctuality, team building and other behaviors aligned to the mission and values of the organization.
Qualifications
- Bachelor's degree in social work or a human service field including but not limited to sociology, special education, rehabilitation counseling, and psychology.
- Meets the requirements for licensure in the State of Iowa as a Social Worker or equivalent degree.
- Two years of related work experience in a hospital, nursing home, or community organization preferred.
- Exhibits good communication skill. Will demonstrate effective communication with patients, their families, and staff to facilitate discharge planning.
- Basic Life Support (BLS) certified.
- Dependent Adult and Child Abuse are required within six months of employment.
- Displays knowledge of community resources, specifically: financial, health, religious, and social services.
- Understands and accepts the possibility of exposure to environmental elements, which may affect the work place such as infectious diseases, chemicals and/or fumes, and adverse effects of inclement weather that may occur.
Hawarden Regional Healthcare cultivates, upholds and supports a safe work environment. Employees support patient and staff safety by demonstrating aptitude and maintaining organizational employment standards and requirements. Employee job performance is continually appraised and formally evaluated during the course of employment with Hawarden Regional Healthcare.
PHYSICAL REQUIREMENTS:
- Must successfully pass employment physical examination and must adhere to applicable organizational requirements on an annual basis for Employee Health Directives.
- Primarily works inside with frequent sitting, walking, standing, bending and occasional lifting of supplies not in excess of 25 pounds.
- Has the physical stamina to meet the requirements of this job description, including frequent walking, bending and standing.
- Able to perform effectively under stressful situations.
- Must be able to communicate both verbally and in writing.
- Must understand and accept the possibility of exposure to environmental elements, such as inclement weather, dust, noise, chemicals and/or chemical fumes, and infectious disease.
These essential functions identify the major requirements of the job. They are not an exhaustive list of all job requirements. An employee may be called upon to perform physical actions not specifically identified in this job description.
