Inpatient Social Worker

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

The senior inpatient care manager is responsible for coordinating the complex discharge planning needs of patients, as well as to do psychosocial assessment and interventions for designated patient populations across the continuum of care. The senior case manager also works with the providers, other case managers, and multi-disciplinary care teams to facilitate the achievement of desired patient, quality, and financial outcomes. In general, senior case managers are assigned to a specific campus. However, all case managers are expected to float to other campuses if the need arises.

JOB DUTIES AND RESPONSIBILITIES:

• Develops a discharge plan that addresses the psycho-social needs to meet desired goals for the next step in the continuum of care for patients.

• Collaborates with the patient, family or other caregivers, and multidisciplinary team to design a discharge plan respective of the patient’s needs and goals. 

• Works as a team with other members of care management, including but not limited to:  other case managers, support center staff, clinical coordinators, utilization management staff, providers and leadership team(s).

• Facilitates communication among all treatment team members.

• Manages length of stay by proactively identifying and mitigating issues and barriers to care and a successful discharge plan.

• Updates the care team, patient/family as to the status of the discharge plans.  Re-evaluates and revises the discharge plan as additional information is acquired.

• Proactively considers options such as palliative care, homecare and other services that work to keep the patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions.

• Issues applicable state/federal regulatory notices as applicable ie.) Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON), Bundle Payment Care Initiative (BPCI) notification.

• Monitors risk of readmission scores using available tools and implements discharge interventions accordingly.

• Actively addresses and monitors resource utilization and documents delays as appropriate.

• Coordinates utilization of patient and community resources to facilitate achievement of a safe and effective discharge plan and accomplishment of goals as well as minimizing risk of readmission.

• Collaborates with Outpatient Care Managers to identify patients for handover and post discharge follow up.

• Provides supportive counseling and advocacy to assist patients and/or family with adjustment associated with illness, hospitalization and/or alternative care placement.  Facilitates the decision-making process in complex cases.

• Facilitates resolution of issues surrounding patient care in a compassionate manner, utilizing team meetings as appropriate.

• Act as resource to the staff for regulatory issues regarding discharge-planning and psychosocial processes.

• Uses electronic systems to accurately document care manager functions.

• Maintains confidentiality of all protected health information (PHI), St. Luke’s proprietary Demonstrates competency in the assessment, range of treatment, knowledge of growth and development and communication appropriate to the age of the patient treated.

• Seeks out educational opportunities specific to the role of care management.

• Precepts new employees as needed.

• Can function in a clinical coordinator role in the absence of the clinical coordinator or manager, depending upon the campus.

• Other related duties as assigned.

PHYSICAL AND SENSORY REQUIREMENTS:

Sitting for one to two hours at a time, walk on all surfaces for up to five hours a day, and climb stairs.  Occasionally firmly grasp, twist, and turn objects with hands and fingers.  May be required to lift, carry, push, and/or pull objects weighing up to 50 pounds.  Occasionally stoops, bends, squats, kneels and reaches above shoulder level.  Staff must have the ability to hear as it relates to normal conversations and high and low frequencies and to touch as related to telephone and computer keyboard.

EDUCATION:

MSW or equivalent. Current NJ SW license if working at St. Luke’s Warren Campus OR RN degree.  Care managers grandfathered through hospital acquisitions without MSW or RN are eligible.

TRAINING AND EXPERIENCE:

Minimum of 5 years inpatient acute care case management experience.  ACM certification required.  For case managers grandfathered into case management through hospital acquisitions without RN or MSW, CCM certification can be substituted for ACM certification.

Please complete your application using your full legal name and current home address.  Be sure to include employment history for the past seven (7) years, including your present employer.  Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable.  It is highly recommended that you create a profile at the conclusion of submitting your first application.  Thank you for your interest in St. Luke's!!

St. Luke's University Health Network is an Equal Opportunity Employer.