To achieve, by case type, a purposeful and controlled connection between the quality of care and the cost of that care across the continuum by providing social work services to those persons who are identified as high volume, high risk and those with complex psychosocial and financial issues which may impact on the management of their care.
Essential Functions:
Will provide Real Time social work services to those persons within the member base who are identified as high volume, high risk and those with complex psychosocial and financial issues (approximately 90 - 100/month)
Will provide social work assessments and formulate appropriate plans of care for approximately 40 members per month through the Geriatric Clinic; will be an integral part of the Elder Care Continuum.
Assessments to include: memory/dementia testing, functional assessments, depression screenings, counseling/adjustment to illness, end of life counseling, and behavioral related issues.
Other social work services to include: placements, indigent medication applications, hospice referrals, and APS referrals
Will utilize the following systems for data retrieval or information input to achieve optimal member outcomes: CMS, BETS/MIPS, Health Connect, QCare, MSView, and KM3
Will scan all documentation into MSView
Accountable for comprehensive social work assessments and formulation of plans of care for high risk members.
Accountable for placements to skilled nursing facilities, intermediate care facilities, and/or assisted living facilities.
Accountable for addressing ethical issues with members and families, which includes the transition to end of life care as appropriate
Acts as a resource for interpreting scenarios, which require social work expertise for non-clinical personnel; provides benefit interpretation as it applies to a specific scenario and facilitates utilization of the most appropriate resources.
Responsible for collaborating and communicating findings with PCPs and/or care teams
Assists with identifying and obtaining community based resources.
Qualifications
Basic Qualifications:
Minimum of five years experience in a geriatric/health care related field (ambulatory setting preferred).
Current license in the State of Ohio as Licensed Independent Social Workers
MSW/MSSA required.
Previous knowledge and experience of nursing home placement and alternate living options
Competency in word processing functions.
Ability to analyze available data to determine appropriate needed care resources.
Previous experience with Medicare regulations and guidelines
Knowledge and experience with other regulatory and accrediting bodies such as Ohio Department of Insurance (ODI) Department of Labor (DOL) National Council for Quality Assurance (NCQA).
Specific knowledge base in acquisition of community based resources.
Proven record of accomplishment of working independently and as a member of a health care team
Proven experience in utilizing operational reports (ie financial customer satisfaction).
Will provide Real Time social work services
Preferred Qualifications:
Certification as Social Work Case Manager-Advanced (C-ASWCM) preferred. Primary Location: Ohio-Willoughby-Willoughby Medical Offices 5105 SOM Center Rd. Scheduled Hours (1-40): 40 Shift: Day Working Days: Mon Tues Wed Thurs Fri Working Hours Start: variable day start Working Hours End: variable day end Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group: Salaried Employees Job Level: Individual Contributor Job: Behavioral/Mental Health Public Department Name: Nursing Administration Travel: Yes 25% of the time Job Eligible for Benefits: Yes External hires must pass a background check/drug screen. We are proud to be an equal opportunity/affirmative action employer. |