Job SummaryThe MSW - Case Management Care Coordinator provides discharge planning and social services support to patients and their families. This role collaborates with interdisciplinary healthcare teams to evaluate patient needs from admission through discharge, ensuring smooth transitions across the continuum of care.Key Responsibilities
- Case Management: Initiate and oversee the case management process to ensure appropriate patient services across the care continuum.
- Discharge Planning: Assess, coordinate, and implement plans for patients' clinical, psychological, and post-discharge needs.
- Interdisciplinary Collaboration: Work closely with physicians, care teams, and community resources to facilitate effective discharge plans.
- Patient Advocacy: Address clinical, psychosocial, and financial barriers to care, ensuring optimal resource utilization and outcomes.
- Education & Counseling: Educate patients and families on community resources, care options, and financial implications of post-discharge plans.
- Documentation: Maintain accurate and detailed records of case management activities and discharge planning notes.
- Utilization Review: Monitor and control healthcare resource use to minimize lengths of stay and improve care efficiency.
- Process Improvement: Track and address barriers to care, developing action plans to enhance processes and systems.
- Patient-Centered Care: Employ Patient Service Excellence principles like AIDET and proactive rounding to enhance the patient experience.
QualificationsEducation:
- Master's degree in social work (MSW) required.
Experience:
- At least 3 years of recent experience in an acute care facility or related healthcare setting.
Skills:
- Strong ability to evaluate and coordinate patient care needs.
- Effective interpersonal, organizational, and problem-solving skills.
- Knowledge of federal, state, and local regulations relevant to discharge planning.
- Familiarity with community resources, post-acute care facilities, and medical equipment providers.
2400 Round Rock Avenue, Round Rock, TX 78681
Education: Masters Degree