Under general supervision, the Social Work Case Manager assesses patient and family Psycho-Social and discharge planning issues relevant to medical treatment. The Social Work Case Manager provides crisis intervention, emotional support, resource information, discharge planning, and legal reporting. The social worker arranges case conferences and facilitates ethical consultations. In addition, the Social Work Case Manager is accountable for coordinating care delivery for an identified caseload of patients in collaboration with medical staff and other members of the interdisciplinary care team. The mission and vision of the organization and any appropriate practice acts governs the practice. Planning for individual age-specific needs will occur as it relates to the assigned patient population including neonate, infant, children, adolescents, adult geriatric.
Performs psychosocial assessments and discharge planning for high risk patients.
Participates in patient care planning responsive to age specific needs.
Refers patients to appropriate community resources.
Provides crisis intervention and emotional support to patients and families on psychosocial issues.
Coordinates patient/family physician conferences.
Provides consultation to physicians and hospital staff re: psychosocial issues, bioethical issues and discharge problems.
Develops and maintains working relationships with community agencies.
Provides in-service education for staff.
Documents pertinent contacts regarding discharge plans in the Social Services notes of the patient’s medical record.
Performs basic administrative tasks related to the job; updating community resource lists, statistics, reports, and other routines as required
Performs legal reports for suspected child abuse and elder abuse and domestic violence referrals
Assesses each patient within identified caseload prior to admission or on first contact with the organization, including clinical, functional, developmental, psychosocial and financial status, within no later than one working day of admission – identifies support systems and available resources.
Develops implements and revises case management plans for each patient, targeting optimal cost/quality outcomes for each episode of care; includes patient/parent/family in plan development as appropriate.
Identifies variances from the case management plan and intervenes rapidly to correct the variance and/or prevent further complications; considers age and developmental level in determining realistic expectations for goal attainment.
Collaborates with physicians and other members of the interdisciplinary care team in evaluating patient progress against the case management plan; revises plan and/or goals as indicated by patient condition; consults resource personnel as appropriate.
Identifies, implements, communicates and documents an appropriate discharge plan upon admission; consults as indicated for complex discharge planning support; ensures smooth transition between care settings; uses age-appropriate communication techniques in communicating discharge plan to patient and family.
Facilitate reimbursement for services provided by communicating clinical information and discharge plans to staff and departments.
Communicates quality concerns to patient care services leadership and/or medical staff department chairmen as appropriate; identifies opportunities for system performance improvement; actively participates in data driven performance improvement activities targeting optimal clinical outcomes for patients of all ages.
Sheridan Memorial Hospital, located on the Eastern Slope of the Big Horn Mountains in Wyoming, is a unique community-centered hospital that balances contemporary medical technologies with an extraordinary commitment to patient satisfaction. For over 100 years, we have brought progressive programs and medicine, superior outcomes, and cutting-edge technology to the people we serve.
For over 100 y...ears, Sheridan Memorial Hospital has been serving our community. Licensed for 88 beds, Sheridan Memorial Hospital is a progressive, state-of-the-art facility in beautiful Sheridan, Wyoming. With sophisticated technology and services beyond what one might expect in a hospital this size, patients can take comfort in knowing they are receiving high quality care. Our patient satisfaction surveys tell us that we are providing exemplary service to our patients and their families. We are proud of our more than 600 experienced and caring employees. Over 45 physicians provide primary medical care and specialty care in more than 15 areas.