Inpatient Care Manager, MSW - Discharge & Care Coordination

1004 Lehigh Valley Hospital; Easton (Northampton County); On-site; USD 70,000 - 100,000; Full time

Job summary

Lehigh Valley Health Network seeks an Inpatient Care Manager-MS W to coordinate comprehensive care across the continuum for designated patients. This role functions as clinician, care manager, and educator within the interdisciplinary team to achieve high-quality outcomes and efficient discharge planning.

The position emphasizes minimizing unnecessary utilization, ensuring timely transitions, and contributing to performance improvement initiatives across LVHN facilities.

Qualifications

• Master’s Degree in Social Work.
• Less than 1 year experience In an MSW internship program.
• Ability to interact with persons from diverse backgrounds.
• Ability to set priorities to coordinate care plans efficiently.
• Knowledge of computer applications and analytical tools.
• Proven leadership skills.

Responsibilities

• Conduct comprehensive assessments at entry to determine LOS, discharge needs and resources; develop and implement individualized care plans with the multidisciplinary team.
• Coordinate safe and timely discharge planning, including post-acute authorizations, transportation, homecare, and facility placements.
• Monitor and manage patient progress through daily reviews and multidisciplinary rounds; identify and resolve barriers to discharge.
• Advocate for patients and families; address clinical, educational, and psychosocial needs; reflect preferences in care continuum.
• Collaborate with multidisciplinary teams and provide patient/family in development and implementation of plans.
• Coordinate team/family conferences to facilitate care progression.
• Refer patients to community-based services/resources for continuum of care needs.
• Develop and maintain knowledge of Medicare, Medicaid, and payer benefits/reimbursement methodologies.
• Assist patients with self-management via in-person, telephonic, and electronic education; encourage adherence to discharge plans.
• Communicate with physicians, patients, families, and team members to facilitate referrals, authorizations, and coordination of discharge.
• Initiate medical assistance applications when needed; follow up with external services regarding applications.
• Maintain current knowledge of Medicare/Medicaid and other payer systems.
• Deliver regulatory notices within established times as applicable to facility.

Skills

Care coordination

Discharge planning

Leadership

Communication

Education

Master’s Degree in Social Work

Tools

EPIC

Job description

Lehigh Valley Health Network seeks an Inpatient Care Manager-MS W to coordinate comprehensive care across the continuum for designated patients. This role functions as clinician, care manager, and educator within the interdisciplinary team to achieve high-quality outcomes and efficient discharge planning.

The position emphasizes minimizing unnecessary utilization, ensuring timely transitions, and contributing to performance improvement initiatives across LVHN facilities.