Job Description:
The Social Work Care Manager works collaboratively with physicians and other members of the health care team to improve the health of patients with chronic conditions or complex needs. The position educates patients and caregivers to help them manage their health care needs. The incumbent facilitates communication, coordinates services, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management.
Job Specifics
Job Essentials
- Identifies patient populations using specific screening criteria including psychosocial screen, medical record review or through referrals for service per department policy/guidelines includes trigger list, timeframes for assessing patient, and pre-screen criteria. Review of medical records, focused reports and/or referral information to gather relevant data per department guidelines. Obtains additional necessary information by interviewing the patient/family/significant other (SO). Assesses patient/member per CMS Condition of Participation (COP) or National Clinical Quality Association (NCQA) standards. Ensures a plan of care is developed and maintained for members receiving care management services consistent with COP/NCQA and department standards.
- Coordinates and facilitates communication among the member/caregivers /representative, members of the healthcare team, and other relevant parties (e.g. referral physicians, community organizations, post-acute providers, other payers, Sales Team, Employer Groups, etc.). Coordinates with appropriate individuals to help ensure consults, testing, procedures are sequenced in a manner that is appropriate to patient clinical condition and supports timely and efficient care delivery. Care Management will actively intervene and resolve/escalate where barriers to service exist across the care continuum. Maintains a current knowledge of community resources. Where necessary performs cost benefit analysis and coordinates authorizations for appropriate level of care. May diagnosis various mental, emotional and behavioral disorders using DSM 5 guidelines. Provides supportive, crisis and other social work interventions as identified. Coordinates and collaborates with external agencies including DCSF, APS, and law enforcement when abuse, neglect or exploitation is suspected or confirmed. May provide therapeutic modalities appropriate to the level of care. Acts within the scope of the Mental Health Practice Act.
Minimum Qualifications
- Master's Degree in Social Work. Education must be obtained from an accredited institution. Degree will be verified.
- Current State Licensure as a Certified Social Worker (CSW) or Licensed Clinical Social Worker (LCSW).
- Basic computer skills and knowledge of word processing and spreadsheet software.
- Strong written and verbal communication skills.
- Demonstrated ability to exercise critical thinking skills.
Preferred Qualifications
- Case Management Certification.
- Experience working in clinical care management, social work or with third party payers.
- Knowledge of care management.
- Knowledge of health insurance related products.
- Working understanding of coding, episode of care and length of stay guidelines.
- Written and verbal communication skills.
- Ability to work independently, be self-motivated, have a positive attitude, and be flexible in a rapidly changing environment.
Physical Requirements:
- Ongoing need for employee to see and read information, labels, assess patient needs, operate monitors, identify equipment and supplies.
- Frequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.
- Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information, medication preparation, etc.
- Need to walk and assist with transporting/ambulating patients and obtaining and distributing supplies and equipment. This includes pushing/pulling gurneys and portable equipment, including heavy items. Often required to navigate crowded and busy rooms (full of equipment, power cords on the floor, etc).
- May be expected to stand in a stationary position for an extended period of time.
Location:
Intermountain Health Logan Regional Hospital
Work City:
Logan
Work State:
Utah
Scheduled Weekly Hours:
24
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$34.06 - $52.55
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits package here.
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.
All positions subject to close without notice.
