Responsibilities
The role of the Department of Emergency Medicine (DEM) Social Worker, MSW is to increase patient throughput to the most appropriate level of care while facilitating interdisciplinary care across the continuum. The DEM Social Worker will assist in identifying patients appropriate for Admission, Observation or other patient care status. The DEM Social Worker will function as a liaison between attending physicians, Physician Advisors, local CCRCs, SNFs, PCFs, patients, families, and the community. The role includes the management of social issues that impact patient classification, discharge from the DEM, and ongoing medical management of patient care needs. The DEM Social Worker will assist in identifying physician and staff documentation opportunities to support Quality and Pay for Performance indicators. The goal is to collaborate with patients, families, and health care providers to promote health and manage illness in a cost-effective and quality-driven manner.
Essential Functions:
- Performs 100% review of anticipated admissions utilizing InterQual criteria to assess for appropriate level of care assignment.
- Certifies Medicare admissions and utilizes Code 44 when appropriate.
- Coordinates and manages inpatient Medicare Discharge expedited appeal requests from the QIO and patients.
- Serves as a resource to patients, physicians, Administration, and hospital employees regarding issues related to patient classification and reimbursement.
- Refers inappropriate Observation or anticipated Admission cases to the Physician Advisor.
- Decreases non-emergency utilization and over-utilization by patients in the DEM.
- Provides real-time interventions to prevent delays and ensure compliance and revenue integrity with health care regulations.
- Identifies and collects data regarding resource utilization for DEM physicians, management, and administration for evaluation and process improvement.
- Functions as a resource to the DEM via communication of new information regarding coordination of care, Case Management, managed care, and the continuum of care.
- Identifies tests, procedures, and interventions earlier to advance the plan of care.
- Intervenes with physicians and ancillary departments concerning clinical and utilization issues to ensure optimal patient outcomes.
Schedule: Every other Saturday and Sunday.
Qualifications
Education and Experience: Master's of Social Work, Over 3 years to 5 years Acute care case management experience required.
Licenses and Certifications: Social Work License in PA, preferred.
Benefits: We offer a competitive salary and comprehensive benefits to part-time and full-time employees including:
- Medical, dental, & vision insurance available 1st of the month after start date.
- Wellness and gym discounts & free cardiac rehab gym.
- 403B.
- On-site discounted childcare center.
- Paid time off.
- Sick time for full-time employees.
- Tuition assistance.
- Free life insurance for full-time employees.
- Long-term disability for full-time employees.
- Short-term disability.
- Employee referral bonus.
- Identity theft insurance.
- Pet Insurance.
- Flexible spending accounts.
- Employee discount program.
- Employee Assistance Program.
- Free parking.
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