Case Manager - Social Worker (per diem)

Sauk Prairie Healthcare, Inc.; Town of Prairie du Sac (WI); On-site; USD 65,000 - 90,000; Part time

Benefits offered by this job

Retirement plan

Fitness facility access

Free parking

Job summary

Sauk Prairie Healthcare, Inc. is seeking a Case Manager – Social Worker (Per Diem) to coordinate social services, support discharge planning, and advocate for patients.

The role emphasizes collaboration with the multidisciplinary team, assessing psychosocial needs, and facilitating community resources to improve outcomes across clinics and hospital settings.

Qualifications

• Bachelor’s degree in Social Work required.
• Master’s degree in Social Work preferred.
• Wisconsin license as a Social Worker preferred: LCSW or similar.

Responsibilities

• Coordinate integration of social services into patient care, discharge, and home planning with the care team.
• Conduct assessments of biopsychosocial needs and identify resources to support outcomes.
• Lead discharge planning, aftercare planning, and care transitions with patients and families.
• Advocate for patients, address psychosocial concerns, and educate staff on resource utilization.

Skills

Case management

Interdisciplinary teamwork

Patient advocacy

Education

Bachelor's degree in Social Work

Master's degree in Social Work

Job description

Looking to be part of a team that provides extraordinary healthcare from the heart? You Belong Here.

Title: Case Manager – Social Worker
FTE: Per Diem
Schedule: As needed
Holiday Rotation: None
Weekend Rotation: None
On Call Requirements: None

POSITION SUMMARY

The Case Manager-Social Worker coordinates and facilitates patient care activities to promote optimum and appropriate utilization of resources, improve continuity of care across the continuum, and to contribute to patient satisfaction and outcomes throughout the SPH organization (clinics and hospital). This position serves as a patient advocate, as a resource to patients/families and staff, and as a leader of the interdisciplinary team continuity of care/discharge planning/aftercare planning/resources. This position also serves as a liaison between the patient, staff, and physician to establish and implement a plan of care for each patient. The Case Manager-Social Worker conducts assessments of the biopsychosocial needs of patients, assists with identification of resources to assure successful outcomes, and facilitates expedited discharges across the continuum of care.

POSITION TECHNICAL RESPONSIBILITIES

• Coordinate the integration of social services/case management functions into the patient care, discharge, and home planning processes with other SPH departments, external service organizations, agencies, healthcare facilities and providing resources to patients as needed.
• Conduct concurrent medical record review using specific indicators and criteria as approved by medical staff, CMS, ACHC, and other state agencies.
• Acts as patient advocate, investigates and reports adverse occurrences, and performs staff education related to resource utilization, SDOH, discharge planning, and psychosocial aspects of healthcare delivery.
• Complete assessment of all patients referred or identified as having complex psychosocial concerns and/or as needing discharge planning services, including data related to home environment, support systems, community agency involvement and psychosocial concerns to determine post-hospital/clinic visit needs.
• Identify, assess, plan, implement, and evaluate individualized patient plan of care that includes clinic care, acute hospital care, discharge plan, transition to home or alternate site, and the use of community resources in conjunction with the multi-disciplinary care team, the patient and their family.
• Address internal and external social, economic, emotional, medical, nursing and psychological needs, through referral, which will extend beyond the hospital/clinics.
• Provide support to patients and families to improve their understanding of an adjustment to the diagnosis to maximize benefits of medical intervention and enhance patient and/or family functioning.
• Identify and works to eliminate barriers to successful and safe discharge/aftercare plan implementation.
• Assess patients for potential needs in a timely manner and identifies those in need of case management intervention.
• Document accurate assessments and interventions in patient’s electronic medical record in an effective and timely manner.
• Mobilize resources and interviews, as needed, to achieve expected goal to assist in achieving desired clinical outcomes within the desired timeframe.
• Identify patients with high risk or high-cost care, coordinate interventions, and facilitates appropriate discharge/aftercare plans.
• Provide post discharge/clinic visit case management to high risk populations.
• Evaluate, plan, coordinate, review, and revise patient continuity of care/discharge plan/aftercare plan based on patient need in collaboration with medical staff and the multidisciplinary team.
• Serve as a resource for patient/families, staff and providers, regarding legal/financial issues impacting patient’s care including advance directives, power of attorney, and guardianship.
• Work collaboratively with the care team and community agencies to assess, plan, and execute appropriate mental health and AODA services.
• Coordinate care delivery processes and promptly intervenes in instances of delayed services or inappropriate utilization of resources.
• Participate in multidisciplinary team meetings regarding the planning and implementation of patient care; facilitate communication and problem solving related to discharge planning.
• Coordinate and leads family conferences and/or multidisciplinary care conferences as needed.

POSITION REQUIREMENTS

• Education: Required: Bachelor’s degree in Social Work Preferred: Master’s Degree in Social Work
• Experience: Required: None Preferred: Two or more years’ experience providing case management in a hospital or clinical setting
• Licenses and Registrations: Required: State of Wisconsin License as a Social Worker Preferred: Clinical Social Worker (LCSW) License
• Certification(s): Required: None Preferred: Advanced Practice Social Worker (CAPSW) Certification, American Case Management Association (ACMA) Case Management certification

BENEFIT SUMMARY

• Retirement plan with immediate vesting and employer match
• Discounted membership to our state-of-the-art fitness facility
• Free parking at facility #IND100

When you choose a career at Sauk Prairie Healthcare, you will enjoy a respectful, collaborative work environment where patient safety and quality are our highest priorities. Whether you’re seeking a job in nursing, medical imaging or another clinical field, or looking to bring your experience and excellent work ethic to one of the many non-clinical roles on our team, you’ll feel like You Belong Here.