Facility: Kennestone Hospital

Job Summary:

Primary liaison between the patient, family, the rehab team, outside agencies and their representatives. The Social Worker/case manager provides information about patient's progress, referrals and educational information and adjustment counseling to patients and their families and coordinates the discharge planning process.
Adheres to NASW professional standards, codes of ethics, system and department policies and procedures. Works as needed on hourly basis.

Core Responsibilities and Essential Functions:

CASE MANAGEMENT
* Reviews all new admissions in EPIC and paper chart for completeness to assure compliance with insurance, pre-certification and DME requirements.
* Documents discharge issues in the chart at appropriate intervals for progress findings.
* Communicates with the team regarding progress and/or insurance issues.
* Communication with insurance providers to obtain episodic authorization.
* Coordinates team goals, the interdisciplinary team conference and the family education process to assure a smooth flow of care until discharge.
* Executes various documents with the patient and family as needed.
* Care coordination and follow-up with patient, family, team and physicians
FINANCIAL RESPONSIBILITY
* Monitors LOS efficiency and facilitates discharge plan process
* Enters necessary financial and precert information into CANOPY to ensure timely flow.
* Works with physician and manager to resolve failed or denied patient approvals.
* Communicates with insurance companies to assure appropriate coverage and claims management.
* Works with families to assure appropriate resource identification, access and utilization
COMMUNICATION
* Communicates with AC and physicians to facilitate benefits and pre-cert information on insurance patients, internal and external referrals.
* Serves as a resource for the interdisciplinary team, regarding insurance compliance issues.
* Communicates to all stake holders regarding patient progress.
* Meets with patients, families, team members and outside case managers to review patient progress, prepare for timely discharge and schedules the education process for patients and families..
Compliance
* Assures authorization for equipment as required by insurance; facilitates discharge prescription assurance.
* Assures documentation meets regulatory standards
* Participates in chart audits as requested
* Works with IRF-PAI Coordinator, physician and interdisciplinary team to assure regulatory and CARF compliance.
Performs other duties as assigned
Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

Associate's Degree in Nursing or graduate of an accredited CSWE Program Required and
Master's Degree in Social Work. Required

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

• Certified Case Manager or Lic Clinical Social Worker GA or Lic Master Social Worker GA or Master Social Worker or Reg Nurse (Single State) or RN - Multi-state Compact

Additional License(s) and Certification(s):

Required Minimum Experience:

Minimum 2 years experience in medical case management inpatient rehab Preferred

Required Minimum Skills:

Demonstrates skills or experience in case management.
Strong computer skills required.
Good communication skills both verbal and written.
Excellent time management/organizational skills;
working knowledge of the precertification process;
Working knowledge of medical terminology and basic computer proficiency required
Demonstrated counseling skills, knowledge of community resources, federal and local guidelines, funding resources;
understanding of adult and geriatric development and age appropriate care
understanding of the effects of illness and disability and the impact on both patient and family.