Emory Healthcare/Emory University Case Mgr/Social Wkr-LMSW,Rehab in Atlanta, Georgia
Independently assesses, implements, coordinates, and monitors options and services to meet health needs of patients using communication and available resources to promote quality, cost effective outcomes.
Validates each hospital admission in accordance with nationally recognized criteria and department policies to determine the medical necessity of admission and appropriate length of stay (LOS).
Intervenes as required with physicians and Interdisciplinary Patient Care Teams to facilitate achievement of targeted LOS.
Issues and administers notices of non-coverage and potential liability to clients in accordance with predetermined regulations, policies and procedures. Facilitates MD to MD reviews as needed.
Maintains an effective flow of information between nursing units, physicians, Medical Records, Business Office and third party payors to facilitate appropriate LOS and to ensure appropriate reimbursement and coverage.
Maintains a cooperative relationship with professionals, physicians and community agency representatives.
Efficiently covers for colleagues as requested, and thoroughly conveys patient care status and plan of care in order to assure continuity and uninterrupted service upon colleagues return.
Thoroughly prepares covering colleagues in advance of planned absences.
Demonstrates the skills necessary to nurture team building and growth in establishing and maintaining a cooperative relationship with professionals, physicians, patients, family members and community agency representatives.
Assumes responsibility for seeking guidance in areas of question by consulting supervisor and other healthcare professionals as necessary.
Acts in a professional, caring, customer service focused manner in all interactions with patients, families, peers, medical team members and community agency representatives.
Assess patients and members of their support system in order to identify potential needs, to determine appropriate level of care for discharge planning purposes and to identify necessary interventions.
Evaluates family, home environment and financial situation in order to develop safe and viable plan of care.
Provides patient and family education regarding discharge planning and community resources.
Provides supportive counseling for patients, families and significant others who are experiencing anxiety or stress due to illness, injury or physical limitations.
Takes an active role in the coordination and facilitation of goal-oriented family meetings. Evaluates, coordinates and acts in accordance with current laws and hospital policies in reporting targeted populations (suspected child/disabled adult/elder abuse or neglect).
Collects and records required Utilization Management information for appropriate management of the patients in the rehabilitation units.
Acknowledges and appropriately prioritizes referrals from interdisciplinary team members, patients, and families with initial chart documentation entered within 24 hours of receipt of consult except for holidays and weekends.
Attends and actively participates in interdisciplinary team meetings in order to screen for high risk patients, obtain and share information, identify appropriate length of stay, advance the patients plan of care, identify and take action to resolve barriers and to coordinate safe and appropriate discharge to the proper level of care within the appropriate time frame.
Maintains focus on the provision of quality service in a rapid and efficient manner in order to transition patients to the appropriate level of care within the time frame of the target length of stay.
Updates the clinical team regarding discharge destination, and date and time of anticipated discharge.
Attends and actively participates in Team Meetings in order to identify and address system trends and barriers to the delivery of efficient patient care.
Collaborates with insurance case managers and community care providers, and initiates referrals to appropriate community resources.
Maintains a thorough working knowledge of Medicare, Medicaid and private payor regulations and processes.
Maintains broad knowledge of resources and options for patients available within all levels of care; facilitates efficient access and movement of patient across levels of care, and coordinates inter-facility transfer of patients to appropriate level of care. Ensures that a safe and timely discharge is attained, with proper documentation and verbal reports shared with receiving facilities or agencies.
Respects the confidentiality of all patient information and conforms to hospital/departmental policies.
Acts as a responsible steward of departments and patient/family’s patient care funds.
Demonstrates a high level of initiative and performs as a self-starter in daily activities.
Performs other related duties as required.
Master's in Social Work.
Two years of recent healthcare experience (one year in rehabilitation preferred) in a hospital setting (within the past five years) and one year of experience in utilization management, quality improvement, or discharge planning.
Positions in this classification require license in the State of Georgia (LMSW).
Case management certification preferred.
PHYSICAL REQUIREMENTS (MediumMax 25lbs):
up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
Connect With Us!
Connect with us for general consideration!
Division Select Rehab JV
Campus Location Atlanta, GA, 30322
Campus Location US-GA-Atlanta
Department RJV Care Coordination
Job Type Regular Full-Time
Job Number 77418
Job Category Therapy
Standard Hours 40 Hours
Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.
Emory Healthcare/Emory University
- Emory Healthcare/Emory University Jobs