Social Worker Care Manager - Care Management *Up to $10,000 Hiring Bonus*
Company: Providence Health & Services
Location: Mission Viejo
Posted on: August 5, 2022
We are looking for a Social Worker Care Manager for the Care
Management Department at Mission Hospital Regional Medical Center.
Up to $10,000 Hiring Bonus for eligible external candidates who
meet all conditions for payment - this is in addition to the
fantastic benefits and compensation package offered by Providence
that begin on your first day of employment. Location: Mission
Viejo, CA Work Schedule: Full time - 80 Biweekly Hours Shift:
8-hour, Days Job Summary: Care Management is a collaborative
practice model including the patients, nurses, social workers,
physicians, other practitioners, caregivers and the community. The
care management process encompasses excellent communication, both
verbal and written, and facilitates care along a continuum through
effective resource coordination and addressing the psych social
needs of the patient. Essential Functions:
- Assessment: The Care Manager Social Worker will collect
in-depth information about a persons' situation and functional
status to identify individual needs in order to develop a
comprehensive plan of care that will address the patient's needs.
The Care Manager Social Worker will identify both present and
possible future needs of the patient and family, which may affect
the plan of care and the patient's well-being. This assessment will
include age-specific physical, psychosocial, environmental,
financial, and health status expectations.
- Planning: The Care Manager Social Worker will identify specific
objectives, goals and actions, as identified during the assessment
process. Acting as a patient advocate, the Care Manager Social
Worker will collaborate with the physician, the patient and family,
and members of the healthcare team, to formulate a shared plan of
care. Goals and time frames for goals, appropriate to the patient,
will be set.
- Implementation: Executes specific interventions that will lead
to accomplishing the goals and time frames of the shared plan of
care. Works effectively with the healthcare team to determine the
necessary steps to achieve the plan of care. Problem solving
techniques will be applied to the implementation process. The Care
Manager Social Worker will utilize knowledge of alternative funding
sources, benefit plans, and contractual information to promote
appropriate quality, cost effective care for members throughout the
- Coordination: Organizes, coordinates, provides, modifies or
obtains appropriate authorizations, utilizing appropriate
utilization review and evidence of coverage guidelines, to
accomplish the patient's goals. Initiates and communicates with the
patient and family, physicians, healthcare members, and community
and payor representatives. Facilitates continuity of care
throughout all access points involving Health Plan, discharge
planners, physicians and other appropriate staff.
- Monitoring: Obtains sufficient information from all relevant
resources in order to determine the effectiveness of the plan of
care, and services provided. Manages a caseload of high risk,
complex needs and/or catastrophic patients.
- Evaluation: At appropriate and repeated intervals, assesses and
reassesses the patients' progress. If progress is static or
regressive, determines the reason and encourages the appropriate
interventions to obtain optimal outcomes. The Care Manager Social
Worker will modify the plan of care, as necessary, in coordination
with the healthcare team, family members, and providers.
- Communication: Communicates both verbally and electronically
with the patient and the healthcare team. Appropriately documents
the plan of care, outcomes, statistical reporting, logs, and files
abiding to departmental, legal and regulatory requirements. Skills:
- Knowledge of managed care principles, utilization management,
case management and healthcare provided throughout the
- Knowledge of physical and psychological characteristics of
disease processes, recognizes potential clinical problems, and
recommends intervention in a preventative, pro-active way.
- Excellent interpersonal, verbal and written communication
- Ability to problem-solve.
- Ability to access and evaluate community resources to meet
- Ability to handle multiple tasks at a time and remain
- Ability to work autonomously but demonstrates the ability to
work collaboratively on a team.
- Ability to work in an ambiguous environment; work effectively
under pressure due to changes in priorities.
- Excellent computer and IT system knowledge.
- Knowledge and skills necessary to communicate with third party
- Establishes and maintains a good rapport with physicians and
interacts well with all internal and external customers in a
professional and courteous manner. Minimum Position Requirements:
Education: Master's Degree in Social Work, Psychology, Counseling,
or Master's Degree with 5 years relevant social work experience.
Experience: 6 months Clinical experience in an HMO, medical group,
affiliated model, hospital or medical/office/clinic setting.
Licenses/Certifications: Valid California Driver's license.
Preferred Position Qualifications: Experience:
- 3 years experience in utilization management or case
- Managed care experience. Licenses/Certifications:
- Certification in Case Management (CCM, ACM). Apply Today!
Applicants that meet qualifications will receive a text with some
additional questions from our Modern Hire system. At Mission
Hospital with locations in Mission Viejo and Laguna Beach, CA our
core values of Compassion, Dignity, Justice, Excellence and
Integrity translate into an environment where the welfare of our
patients always comes before the bottom line. As a member of
Providence Health System, we serve all of south Orange County.
Mission Hospital Mission Viejo is a Level II Trauma Center and is
the area's designated regional trauma center. We have Centers of
Excellence in heart, maternity, trauma, breast care, spine,
vascular, stroke and brain injury. Mission Hospital Laguna Beach
provides local coastal communities with 24-hour emergency
department services, medical/surgical services, behavioral health
programs including inpatient and outpatient psychiatric and
chemical dependency services and an outpatient eating disorder
program. Mission Surgery Center performs approximately 4,500 annual
surgeries and provides a safe and convenient outpatient setting. It
is accredited by the Accreditation Association of Ambulatory Health
Care. We've received two Beacon Awards for clinical excellence and
in 2012 we received Magnet Designation which recognizes hospitals
for top patient care, quality nursing and innovations in nursing
and healthcare. We offer a collegial work environment with
competitive salaries and benefits. Mission Hospital provides equal
employment opportunities (EEO) to all employees and applicants for
employment without regard to race, color, religion, sex, national
origin, age, disability or genetics. In addition to federal law
requirements, Mission Hospital complies with applicable state and
local laws governing nondiscrimination in employment in every
location in which the company has facilities. This policy applies
to all terms and conditions of employment, including recruiting,
hiring, placement, promotion, termination, layoff, recall,
transfer, leaves of absence, compensation and training. Positions
specified as "on call/per diem" refers to employment consisting of
shifts scheduled on as "as needed basis" to fill in for staff
vacancies. Company: Mission Hospital Regional Medical Center
Category: Social Work Req ID: R343251
Keywords: Providence Health & Services, Mission Viejo , Social Worker Care Manager - Care Management *Up to $10,000 Hiring Bonus*, Executive , Mission Viejo, California
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