US:NV:Carson City Case Management
Full Time Day Shift
Summary
-
This individual is responsible to facilitate care through the continuum utilizing effective resource coordination to promote optimal access to care balancing the patients’ resources and right to self-determination.
-
The overall responsibility to assess the patient for transition of care needs and risk for readmission.
-
This individual will be able to conduct complex psycho-social assessments and provide interventions to assist with throughput, safe discharges and avoid readmissions.
Qualifications
Required:
- Bachelor in Social Work from accredited school of Social Work
-
Excellent interpersonal, written and verbal communication skills
- Demonstrated organizational skills, critical thinking and problem solving skills and computer literacy
-
Unrestricted licensure in the State of Nevada
-
Licensed Social Worker (LSW)
Preferred:
- Ability to obtain Master in Social Work from accredited school of Social Work
-
Two (2) years of acute care coordination experience
- Ability to obtain Accredited Case Manager (ACM) certification
Unit Specific Requirements
Behavioral Health Services
Required:
- Non-Violent Crisis Intervention (NVCI)
-
If hired prior to 8/6/2023, must successfully complete NVCI by June 30, 2024.
-
If hired after 8/6/2023, must successfully complete NVCI within six (6) months of hire or position entry.
-
Current, unrestricted driver's license
Essential Functions
Transition Management
- Completes initial /comprehensive assessment within 24 hours of admission, including anticipated transition (discharge) plan
-
Provides psycho-social assessment and intervention for patients identified with behavioral health issues, lack of social support systems, financial barriers, end of life and plan of care adherence
-
Ensures plan of care and interventions are implemented and communicated to health care team, patient/family and post-acute care providers
-
Complete timely, accurate and concise documentation in the EMR
Care Coordination
- Screens high risk and referred patients for psycho-social issues/barriers, that may impact the transition plan and intervenes as appropriate
-
Assists with adoption/abuse/neglect cases and reports to appropriate external agencies as required
-
Collaborates with patient/family/health care team to ensure patient preferences and choices are taken into consideration within the limitations of available resources
Education
- Ensure patient/ family receive education appropriate to their specific discharge plan
-
Provides education to medical and nursing staff regarding relevant issues related to transition plan
Compliance
- Ensures compliance with local, state and federal regulations and accreditation requirements
-
Operates within social work scope of practice as defined by the state licensing board
Complex Case Management
- Completes clear, concise and accurate initial/discharge planning/complex psycho-social assessments and reassessments per departmental guidelines (assessments within 24 hours of admission, reassessments every 3 days or as needed for change)
-
Escalates barriers to transition planning per departmental escalation plan
-
Completes post-acute referrals within 3 days of admission
-
Schedules and facilitates complex case patient/family conferences as needed (at a minimum of weekly)
