The posting
Job Description
The Case Manager Social Services directs the utilization review of patient charts, treatment plans, and discharge planning pertaining to the quality of care and treatment criteria for patients in a specific department. The Case Manager Social Services specializes in the review of information pertaining specifically to the assigned areas. Relies on education, experience, professional training and judgment to accomplish responsibilities. A wide degree of creativity and latitude is expected. Works under minimal supervision. Directs the utilization review of patient charts and treatment plans pertaining to the quality of care and treatment criteria for patients in a specific department. The Case Manager Social Services specializes in the review of information pertaining specifically to the assigned area (i.e.: Case Management, Geriatrics, Mental & Behavioral Health, Home Health). Most, but not all, of the accountabilities below may apply to each specific area.
Responsibilities
1. Evaluation and Analysis a. Assists in patient admission, transfer, and discharge in a caring and compassionate manner and strives to make the patient's stay as pleasant as possible. b. Conducts intensive patient and caregiver assessment and evaluation in order to identify patient and caregiver needs and immediate and long-term recommendations in a manner sensitive to the overall health and well-being of the patient. c. Utilizes all equipment, supplies, facilities, and resources in a prudent and efficient manner in order to ensure efficient departmental operations and the provision of high-quality health care services.
2. Partnership and Collaboration a. Serves as a liaison between hospital providers, family, patient/member, and physician by working to resolve complaints in an efficient manner while keeping the patient's best interests in mind. b. Provides suggestions for program development and offers evaluations of existing programs in an effort to increase program performance and identify ways to improve the quality and efficiency of health care service delivery. c. Manages patient throughput efficiently and serves as information source for community resources. Assists patients/families by coordinating post-discharge needs such as ordering DME, setting up continuation of care/services, setting up Home Health services, making appropriate referrals to community support groups, etc. d. Coordinates concurrent utilization review and serves as liaison with payor sources. Provides updates to payors in timely manner in order to ensure appropriate utilization of hospital resources.
3. Quality a. Develops and coordinates high quality patient treatment plans based on patient assessment and evaluation, careful analysis of family dynamics, and assessment of individual patient care needs. Strives to enhance patient health and promote the high-quality health and wellness services provided by the department. b. Acts as an information and referral source by developing cooperative agreements with community agencies and services in an effort to meet patient needs and ensure that treatment is immediately relevant to the problems the patient is experiencing. c. Fosters an organizational climate that supports and promotes effective continuous quality improvement efforts. Ensures that appropriate priority is given to the continuous quality improvement process and that the quality management practices of the organization are congruent with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and other regulatory entities. d. Observes and adheres to all departmental and hospital policies and procedures, and follows all safety, quality assurance, and infection control standards. e. Promotes the quality and efficiency of his/her own performance by remaining current with the latest trends in field of expertise through participation in job-relevant seminars and workshops, attendance at professional conferences, and affiliations with national and state professional organizations.
4. Other Duties as Assigned a. Performs other duties as assigned or requested.
Qualifications
Experience Some previous experience in social work
Education Master's degree
Licensure Current LCSW License
About Us
Our Lady of the Lake is uniquely capable of caring for a full range of illness or injury, including those that are extremely complex, for both pediatric and adult patients. Our family of services includes:
- An 988-bed hospital and the area’s only Level I Trauma Center
- A freestanding Children's Hospital
- A 545-provider care network covering more than 40 specialties
- Two free-standing emergency rooms—Our Lady of the Lake Livingston and Our Lady of the Lake North
- A network of nearly 15 urgent care clinics
- Outpatient imaging and surgery centers
- Assumption Community Hospital
- Franciscan Missionaries of Our Lady University
- Our Lady of the Lake Ascension, a 78-bed, community hospital providing emergency, inpatient, outpatient, and surgical services to Ascension Parish and surrounding areas
We serve 38,000 inpatients and 820,000 outpatients annually and are committed to building a healthy community through excellence in patient care and education. A part of FMOL Health, Our Lady of the Lake is consistently awarded for compassionate care, clinical expertise, leading edge technology and innovation.
