Summary

1.0 FTE day shift (0800-1630) M-F. Positions requires 2-3 weekends per year coverage. Occasional on-call and occasional holiday coverage. Master of Social Work (MSW) degree required. State licensure not needed.

Job Description

Position is located at Lancaster General Hospital, Lancaster, PA.

HOURS: Fulltime, 80 hours/2 weeks. Day shift (0800-1630) M-F with 2-3 weekends per year with occasional on call and occasional holiday

SUMMARY: Acts as an advocate for the patient, assisting them to reach optimal function and health in an appropriate environment that would support their needs. The Case Manager functions within the full scope of practice to include the major responsibilities of the position and to extend these responsibilities beyond the episode of care to encompass coordination of care across the continuum. The Case Manager applies the processes of assessment, planning, implementation, monitoring, evaluation, and coordination of care to meet the patients’ health care needs across the continuum in collaboration with health team members, community members, to ensure safe, quality and cost effective care.

FUNCTIONS:

• Conducts assessments of patient/family needs by coordinating input from all health professionals and formulating a documented plan assuring continuity of care for the rising and high risk patients.
• Delegates care coordination based on situation while assuming accountability for patient outcome. Supports assistive personnel; serves as a resource and holds assistive personnel accountable to complete delegated tasks.
• Identifies appropriate providers, facilities, external healthcare organizations throughout the continuum of care and communicates with an interdisciplinary treatment team to develop and maintain positive working relationships with patients, families and providers.
• Functions as a coordinator and manager of a defined health population across care setting and for multiple physicians/health care providers or health plan counterparts. Works closely with their assigned primary care department/practice to offer individualized assistance with improving and maintaining quality patient care.
• Coordinates care across the continuum (inpatient/outpatient/community) to assure appropriate utilization of clinical and community resources.
• Oversees and guides the development of multiple health partnerships to achieve a positive health effect.
• Participates on a team for data collection, health outcomes reporting, clinical audits, and programmatic evaluation related to initiatives.
• In conjunction with the practice team, identifies patients at risk for poor outcomes or experiencing poor coordination of services who would benefit from more intensive follow-up.
• Provides chronic disease and self-management education and support.

REQUIREMENTS:

• An Social Worker is required for this role, with specific requirements being one of the following
  • Social Worker: Master’s degree in Social Work (MSW) or a Bachelor's degree in Social Work (BSW) with a Master's degree (MS) in Human Services from an accredited school or program

  • A RN with current licensure as a Registered Nurse, issued by the Pennsylvania Board of Nursing will be considered for this role with relevant complex care management experience. Bachelor’s degree in Nursing (BSN) or a related health care degree is required.

• Three (3) years of acute care nursing or social work experience is required.
• Excellent verbal and written communication skills.
• Excellent customer service skills.
• Proven informal leadership skills.
• Ability to work independently, setting priorities to coordinate care plans efficiently.
• Ability to work effectively in a fast-paced team environment.
• Highly organized and detail-oriented with the ability to perform multiple tasks simultaneously.
• Effective behavioral and educational strategies, including, but not limited to: motivational interviewing, teach-back method and self-management support.
• One (1) year experience in case coordination and planning as well as experience in project implementation and execution is required.
• Demonstrated experience successfully working among multi-disciplinary teams.
• Five (5) years of case management experience is preferred.
• Case Management certification (ACM/CCM) within 3 years.
• Knowledge of utilization review or managed care is preferred.
• Care management experience in a managed care setting is preferred.

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