Clinical Social Worker MSW Position Available In Passaic, New Jersey

Job Description:

About the Department Coordinates the care for groups of patientsas it relates to disease management, resource utilization, access,discharge planning, quality, service and efficiently across thecontinuum. This is an interventional role maintaining a patientcentered focus. Scope of work Under general direction, integratescost, quality and utilization to facilitate the admission,continued stay and discharge of the patient. Reviews and evaluatesappropriateness of admission or continued stay based on medicalnecessity. The overall goal of the position is to enhance thequality of patient care and engagement, to promote continuity ofcare and cost effectiveness through the integration and functionsof utilization management, and/or care coordination, dischargeplanning, and appropriate care transitions. Has accountability forthe care coordination and discharge planning of all hospitalizedpatients. 1. Identifies patients that need care management services(i.e. utilization review; care coordination; and/ordischarge/transition planning). 2. Responsible for managing a caseload of patients that includes facilitating utilization management,and/or care coordination during the patient’s stay, planning andexpediting plans for safe and effective discharge and transition tothe appropriate level of care and setting needed afterhospitalization. Coordinating care by considering all patient’sneeds. 3. Uses critical thinking and effective judgment todetermine alternative courses of care. Judiciously uses toolsdesigned to expedite care while being cost effective. Activelyparticipates in readmission initiatives and strategies to maximizepatient flow and appropriate resource utilization. Workscollaboratively on processes to provide effective transition forpatients utilizing hospital outpatient, observation or inpatientservices. 4. May review cases for medical necessity, uses InterQualand/or other UR/UM Committee-approved medical necessity screeningcriteria, when appropriate. Works collaboratively withdepartmental, revenue cycle, and clinical appeals staff,physicians, and payers to obtain authorization for care andappropriate reimbursement. Determines and assures appropriatestatus and level of care. Uses defined resources to guidedecisions, including Medical Director Care Management, PhysicianAdvisors, and management staff. 5. Routinely communicates withpayers, patients/family caregivers, physicians, theinterdisciplinary team, post-acute and community-based careproviders to facilitate coordination of care and to enhance aseamless transition from hospital setting to the appropriatealternative level of care. 6. Seeks out information and resourcesto apply creative problem solving for complex discharge/transitionplanning, quality of care, and utilization management issues.

Provides notification and communication to patients/familiesregarding coverage for hospital and post-acute services, inaccordance with CMS regulations. 7. Documents utilization reviews,utilization management actions, care management assessment(s), careplan, discharge plan, and interventions, according to policies,procedures, and regulatory, contractual, and legal requirements.

Acts proactively to see that hospital resources are utilizedappropriately. 8. Works collaboratively with other departments todefine areas of hospital inefficiency and participates inimprovement projects. This document represents the major duties,responsibilities, and authorities of this job, and is not intendedto be a complete list of all tasks and functions. It should beunderstood, therefore, that incumbents may be asked to performjob-related duties beyond those explicitly described.

Qualifications Required Bachelor’s Degree Graduate of an accreditedschool of nursing. Preferred Will consider non-BSN RN if activelypursuing a bachelor’s degree in nursing with completion within 2years of hire. 2 years of relevant experience Minimum two years’experience in the acute care setting. Required 3 years of relevantexperience Three to five years’ experience in care management,utilization review, home care and/or discharge planning. PreferredRegistered Nurse (RN)

• State of Michigan License Upon Hirerequired How Corewell Health cares for you Comprehensive benefitspackage to meet your financial, health, and work/life balancegoals.

Learn more here . On-demand pay program powered by PayactivDiscounts directory with deals on the things that matter to you,like restaurants, phone plans, spas, and more! Optional identitytheft protection, home and auto insurance, pet insuranceTraditional and Roth retirement options with service contributionand match savings Eligibility for benefits is determined byemployment type and status Primary Location SITE

• Wayne Hospital
• 33155 Annapolis
• Wayne Department Name Care Management
• WayneEmployment Type Full time Shift Day (United States of America)Weekly Scheduled Hours 40 Hours of Work 8:00 a.

m. to 4:30 p.m. DaysWorked Monday to Friday Weekend Frequency Variable weekends

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This career site is forNon-Corewell Health team members only. Corewell Health is committedto providing a safe environment for our team members, patients,visitors, and community. We require a drug-free workplace andrequire team members to comply with the MMR, Varicella, Tdap, andInfluenza vaccine requirement if in an on-site or hybrid workplacecategory. We are committed to supporting prospective team memberswho require reasonable accommodations to participate in the jobapplication process, to perform the essential functions of a job,or to enjoy equal benefits and privileges of employment due to adisability, pregnancy, or sincerely held religious belief. CorewellHealth grants equal employment opportunity to all qualified personswithout regard to race, color, national origin, sex, disability,age, religion, genetic information, marital status, height, weight,gender, pregnancy, sexual orientation, gender identity orexpression, veteran status, or any other legally protectedcategory. An interconnected, collaborative culture where all areencouraged to bring their whole selves to work, is vital to thehealth of our organization. As a health system, we advocate forequity as we care for our patients, our communities, and eachother. From workshops that develop cultural intelligence, to ourinclusion resource groups for people to find community andempowerment at work, we are dedicated to ongoing resources thatadvance our values of diversity, equity, and inclusion in all thatwe do. We invite those that share in our commitment to join ourteam. You may request assistance in completing the applicationprocess by calling 616.486.7447.