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Medical Social Worke - Case Manager LECOM Medical Center and Behavioral Health Pavillion - 3.2 Erie, PA Job Details Full-time 1 day ago Benefits Health insurance Dental insurance Paid time off Vision insurance Employee discount 403(b) Life insurance Referral program Pet insurance Qualifications Bachelor's degree in social work Bachelor's degree Stakeholder relationship building Full Job Description Social Services Case Manager LECOM Medical Center & Behavioral Health Pavilion - Erie, PA Full-Time | 40 Hours per Week Join Our Team LECOM Health is seeking a compassionate, detail-oriented Social Services Case Manager to join our Case Management team. In this role, you will coordinate patient care, discharge planning, utilization review, and social service interventions to ensure patients receive the appropriate level of care and support throughout their healthcare journey. This position plays a vital role in collaborating with patients, families, healthcare providers, insurance payers, and community resources to promote positive patient outcomes and smooth transitions of care. What You'll DoCase Management & Discharge Planning Conduct comprehensive patient assessments and identify social, emotional, and discharge planning needs. Develop and coordinate individualized discharge plans. Connect patients and families with community resources, home health services, durable medical equipment (DME), rehabilitation facilities, skilled nursing facilities, assisted living communities, and other support services. Work closely with physicians, nursing staff, therapists, and interdisciplinary teams to coordinate care and ensure continuity throughout hospitalization and discharge. Utilization Review Review medical records to evaluate medical necessity, appropriate level of care, and continued hospital stays. Perform admission, concurrent, and retrospective reviews using established criteria. Communicate with insurance providers to obtain authorizations and provide clinical updates. Participate in payer appeals and peer review processes as needed. Prepare and submit appeals and retro-authorization requests. Patient Advocacy & Support Provide social service interventions and counseling support when appropriate. Assist patients and families with advance directives and related documentation. Coordinate referrals to community agencies, financial counseling resources, protective services, and other support programs. Serve as a resource for patients, families, healthcare providers, and external agencies. Regulatory Compliance & Quality Assurance Ensure compliance with Medicare, Medicaid, third-party payer requirements, and regulatory standards. Complete required CMS and ACHC documentation. Participate in quality improvement initiatives, data collection, and outcome monitoring. Maintain accurate and timely patient documentation. QualificationsEducation Bachelor's Degree in Social Work required. Experience Minimum of 2-3 years of experience in Social Services, Case Management, Healthcare Coordination, or a related field preferred. Knowledge, Skills & Abilities Strong understanding of healthcare systems, discharge planning, and utilization review practices. Excellent verbal and written communication skills. Ability to build effective relationships with patients, families, providers, and community organizations. Strong organizational skills with attention to detail. Ability to manage multiple priorities in a fast-paced healthcare environment. Commitment to maintaining strict confidentiality and professionalism. Working Conditions Primarily office-based within a hospital setting. Frequent interaction with patients, families, healthcare professionals, and community agencies. Exposure to a fast-paced environment with changing priorities and occasional emotionally challenging situations. Why Join LECOM Health? Meaningful work that directly impacts patient outcomes. Collaborative, multidisciplinary healthcare environment. Opportunities for professional growth and development. Comprehensive benefits package for full-time employees. Competitive compensation. Apply today and become part of a team dedicated to providing exceptional patient-centered care throughout our community.

Benefits:

403(b) Dental insurance Employee discount Health insurance Life insurance Paid time off Pet insurance Referral program Vision insurance

Work Location:

In person