Family Birth Place Case manager- Social Worker

$31 - $53/Yr

University of Maryland Medical Center Baltimore Washington - Bel Air, MD

Full-time - Entry Level

Bel Air, MD

1,001-5,000 employees

Hospitals

About the position

Responsible for case managing patients accessing care through Upper Chesapeake's Family Birthplace and Special Care Nursery. Performs utilization review and discharge planning for all patients. Works collaboratively with inter-disciplinary team to assess plan of care, monitor progress and make recommendations the safest and most efficient hospitalization is achieved. Orients new team members. Position requires 24-hour accountability for planning, organizing, and directing case management activities. May interact with patients or customers ranging in age from newborn to adult.

Responsibilities

• Identify and prioritize insurance reviews
• Review appropriateness of admissions
• Assess patient plan of care against established criteria
• Document relevant clinical indicators to establish acute care needs
• Communicate daily concurrent review to payor
• Document any authorizations obtained
• Communicate with attending physician regarding patients not meeting acute care criteria
• Coordinate change in care plan, additional documentation or discharge orders
• Consult with physician advisor as needed
• Monitor all 'pended' days and attempt resolution with attending physician and/or physician advisor as appropriate
• Inform Denials NCM of any denials and provide any information needed
• Identify patients requiring issuance of HINN or Condition Code 44
• Coordinate with Audit Analyst to ensure documentation is accurate
• Communicate with Physician Advisor, Attending Physician and Director
• Discuss regulations with patient/family
• Screen all patients to identify needs and prioritize caseload
• Assess patient/families within the caseload to identify physical, social, psychological, and financial needs
• Perform and document psychosocial assessments
• Collaborate with patient/family to identify appropriate options for discharge planning
• Coordinate with post acute facilities/vendors to ensure smooth transition to next setting
• Have knowledge of patient plan of care
• Actively participate in rounds to ensure continuity of care is communicated with other disciplines
• Identify and refer cases for abuse reporting
• Collaborate with Harford Co Govt agencies to ensure continuity between UCH and Child Protective Services(CPS)
• Develop education for CRM team members to ensure everyone is aware of signs of abuse and are comfortable with CPS referral process
• Maintain accurate timely documentation of actions/services
• Identify need for, arrange, and facilitate case management conferences when necessary to advance the coordination of complex cases
• Assist with special projects and other duties as assigned

Requirements

• Master's degree in Social Work accredited by Council on Social Work Education (CSWE)
• LMSW (Licensed Master Social Worker) licensure from the Maryland Board of Social Work Examiners
• Minimum one (1) year of related experience
• Clinical experience with obstetric, newborn or pediatric population required
• Acute care hospital experience preferred
• Experience in Case Management or Utilization Management preferred
• Basic computer skills required

Nice-to-haves

• Demonstrate skill in general social work and/or case management practice areas
• Ability to communicate and collaborate effectively with both internal and external stakeholders
• Ability to assess, adapt, and calmly respond to changing and/or crisis environment
• Ability to make decisions consistent with current policies, procedures, and ethical standards while operating under supervision
• Ability to prioritize work assignments and manage time effectively

Benefits

• Pay Range: $31.99-$53.45