About the role

  • Inpatient Registered Nurse or Social Worker Care Manager coordinating discharge planning and psycho-social interventions. Working with interdisciplinary teams to facilitate patient outcome and care management.

Responsibilities

  • Assess the patient’s needs, goals, and barriers in relation to the patient’s clinical condition, psychosocial environment, and socioeconomic resources
  • Collaborate with the multidisciplinary team to plan, implement and evaluate the patient’s plan of care through rounding or other methods
  • Collaborate with the patient, family or other caregivers, and multidisciplinary team to design a discharge plan respective of the patient’s needs and goals
  • Re-evaluate and revise discharge plan of care as additional information is obtained or goals change
  • Proactively considers options such as palliative care, home care and other services that work to keep the patient as healthy as possible in the outpatient setting, minimizing the risk of re-admissions
  • Works as a team with other members of care management, including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director
  • Facilitates communication among all treatment team members
  • Manages length of stay by proactively identifying and mitigating issues and barriers to care and a successful discharge plan
  • Monitors risk assessment using available tools and implements discharge interventions accordingly, minimizing risk of readmission
  • Identifies patients with an unplanned readmission and completes root cause analysis
  • Collaborates with Outpatient Care Managers to identify patients for handover and post discharge follow up

Requirements

  • MSW or equivalent from an accredited school of social work
  • Current NJ SW license if working at St. Luke’s Warren Campus
  • May hire per diem BSW’s currently in school within 6 months of completing MSW
  • Graduate of professional nursing program
  • Registered Nurse with current license to practice in the State of Pennsylvania or seeking Pennsylvania licensure through reciprocity
  • NJ RN licensure required for Warren Campus
  • Advanced degree preferred
  • BSN required or obtained within 3 years of hire, MSN and/or Case Management Certification preferred
  • Preference is for at least two years of experience as an RN or Social Worker in an acute hospital setting
  • Previous care management experience is preferred
  • Strong critical thinking skills
  • Knowledge of medical terminology required
  • Basic computer skills required

Benefits

  • Health insurance
  • Flexible working hours
  • Paid time off
  • Professional development opportunities

Job title

Inpatient Registered Nurse, Social Worker (MSW), Care Manager

Job type

Experience level

JuniorMid level

Salary

Not specified

Degree requirement

Postgraduate Degree

Location requirements

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