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Case Manager

Thomas Jefferson University & Jefferson Health
United States, Pennsylvania, Philadelphia
Dec 23, 2024

Job Details

Provides social work services, assesses and enhances the patient's/family's/significant other's ability to cope with physical, emotional and environmental problems related to illness/convalescence and discharge plan. Works collaboratively with the multidisciplinary healthcare team to establish a discharge plan for the patient.

Job Description

Essential Functions

  • Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.
  • Conducts psychosocial assessment/reassignment of patients/significant others relating to the social, emotional and cognitive capabilities of patients in relationship to their illness and health maintenance needs.
  • Develops and implements a plan of intervention that addresses identified needs related to needs/problems identified during assessment.
  • Collaborated with the multidisciplinary team to ensure appropriate discharge planning
  • Provides counseling for patient/family/significant others to assist with coping with new diagnoses, chronic illness and palliative or terminal care
  • Advocates on behalf of the patients/families to enable them to obtain necessary services.

Competencies (Knowledge, Skills, and Abilities Required):

Knowledge of: Medical terminology and disease process; Community resources; Insurance regulations and requirements

Skill in: Work with multidisciplinary teams, outside resources, patients/families/significant others

Ability to: Establish an appropriate plan to safely discharge patients to the next level of care

Minimum Education and Experience Requirements:

Education:

Graduate from an accredited Masters of Social Work program required. Masters of Social Work required.

AND

Experience:

Minimum of 2 years hospital based social work experience.

Minimum Certifications, Registration or License Requirements:

Active LSW or LCSW required for New Jersey positions and preferred for Pennsylvania positions.

Additional Information

Other Functions (in addition to Essential Functions)

  • Serves as a resource and provides counseling and intervention related to treatment decisions and end of life care issues.
  • Refers patient/significant other to community based services/resources to meet patient's continuum of care needs.
  • Coordinates team and/or family conferences when necessary to facilitate patient's care progression.
  • Provides psychosocial counseling and crisis interventions to patients/significant others with needs. Provides interventions in cases involving child abuse/neglect, domestic violence, elder abuse and institutional abuse. Provides intervention in cases involving guardianship, foster care, adoption, psychiatric assessment and placement, Advance Directives (Center City), trauma and substance abuse.
  • Facilitates completion of all placement related documentation in nursing home grants, applications, etc. Completes referrals to options programs where appropriate.
  • Documents in accordance with hospital and departmental requirements.
  • Works with Case Managers in providing discharge planning services per departmental policies and procedures in collaboration with the multidisciplinary team and patient/family.
  • Identifies patients and locates family and/or next of kin.
  • Educates patients/significant others on the process for obtaining health insurance. Provides appropriate documents/information to apply for welfare insurance.
  • When necessary, initiates medical assistance application in a timely manner (Center City) or ensure medical assistance application has been initiated by identified external agencies (excludes Center City). Follows up with identified external service regarding application.
  • Provides psychosocial assessment and intervention as well as documents in the electronic medical record updates throughout patient's hospitalization, discharge planning process and relevant post-acute care
  • Supervises field placement of MSW students.
  • When appropriate, refer case to the Placement Official Social Worker to assist in obtaining placement for the patient's discharge (Center City and Abington/Lansdale).
  • Precept and mentor new staff members to their role and department.
  • Provides on call services to meet the patient's social/discharge needs after hours.

Work Shift

Rotating (United States of America)

Worker Sub Type

Regular

Primary Location Address

5501 Old York Road, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

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