Facility: Wellstar MCG Health

Job Summary:

TheCareCoordinator-MSWprovidesguidanceandeducationtopatientsandfamiliesandisresponsibleforassessingthe psychosocial needs and coordination of care for a designated population of patients. Exhibits a deep understanding of each patient’s medical needs, insurance coverage, health literacy, and other socioeconomic factors that may impact

theiropportunityforwellness.Aidsandassistspatientsinovercominganybarrierspresentedbytheseelements

Essential Functions:

1.  Evaluates the plan of care for individual patients and/or patient populations, utilizing nationally recognized medical necessity criteria, to assure that care is based on accepted standards, evidence-based practice, and

current research.

2.  Collaborates with patients, families, case managers, care coordinators, and nurse navigators to include insurance companies to coordinate patients’ transition to and from various levels of care. Initiates referrals

to outside providers as appropriate to assure timely progression and continuity of care. Conducts an appropriate level of psychosocial assessments within 24 hours of receiving a referral on all patients referred for social work services.

3.  Identifies the opportunity for quality improvements in both inpatient and outpatient care transition and ensures compliance with applicable regulations. Represents the care coordination department on various

teams and performance improvement activities addressing opportunities to improve clinical progression and coordination of care and strengthen evidence-based practice.

4.  Maintains professional certifications, self-identifies, and self-manages training opportunities. Continuously involved in professional organizations and outside professional development opportunities. Keeps up-to

date with research literature and industry best practices and may participate in specialty related research.