Orlando Health
Care Coordinator - Case Management Social Worker, Masters Level
Orlando Health, Orlando, Florida, us, 32885
Position Summary
This position will discharge planning and treatment planning. The candidate will be prepared for individual and group interviews. We are looking for someone with experience in the hospital and who is well versed in adults and children. The hospital has 285 beds and you will be assigned patients daily to care for. This is not a remote job and requires you to show up in person and interface with our patients.
Responsibilities Collaborates with the assigned clinical team to identify patients most likely to benefit from care coordination services to include assessing patients’ risk factors and the need for care coordination, clinical utilization management and preventative care services.
Takes the lead in ensuring continuity and consistency of care across all settings to ensure integrated delivery, including comprehensive discharge planning and outpatient follow-up.
Develops effective working relationships with Patient and Family Counselors, Social Workers and UR nurses to engage patients/families, advocate and problem solve, supporting functional ability and timely discharge plans.
Daily monitors progress toward discharge plans and may alter plans due to patient condition or family needs, prioritizing patients at highest risk for complications, admission and readmission.
Educates patients and families with chronic illness about evidence‑based standards of care including self‑management strategies.
Identifies support needs for patients/families, develops action plans and provides guidance in initiating and overcoming self‑management strategies.
Ensures patients have access to prescriptions, durable medical equipment (DME) and other services as identified.
Contributes to problem solving within the team through communication, collaboration, data collection, obtaining consensus and evaluating outcomes of treatment options, tracking patient progress toward care plan goals and revising the care plan as indicated.
Advocates for patients to optimize health care needs including safety, physical, legal and financial well‑being.
Refers patients for education regarding health care delivery, reimbursement systems, prescription drug programs, health & wellness programs, community agencies, housing options and other services as appropriate.
Works with available IT resources (Phytel, Crimson) to facilitate registry reporting and maintenance of specified patient populations to improve disease outcome measures through evidence‑based guidelines and clinical decision support tools, referral and test tracking and preventive medicine reminders.
Participates in clinical outcome measurement to identify strategies that promote population health.
Ensures patient safety in performing job functions supporting policies, procedures and standards.
Maintains regular, punctual attendance consistent with Orlando Health policies, ADA, FMLA and other standards.
Maintains compliance with all Orlando Health policies and procedures.
Qualifications
Master’s degree from an accredited school of Social Work, Mental Health, Psychology or Marriage and Family Therapy is required.
Handle with Care (HWC) Certification is required for Behavioral Health Unit.
Two (2) years of direct clinical experience with emphasis on the population to be served in the assigned area. Successful completion of Master’s level internship within the population may substitute for two (2) years of experience.
#J-18808-Ljbffr
Responsibilities Collaborates with the assigned clinical team to identify patients most likely to benefit from care coordination services to include assessing patients’ risk factors and the need for care coordination, clinical utilization management and preventative care services.
Takes the lead in ensuring continuity and consistency of care across all settings to ensure integrated delivery, including comprehensive discharge planning and outpatient follow-up.
Develops effective working relationships with Patient and Family Counselors, Social Workers and UR nurses to engage patients/families, advocate and problem solve, supporting functional ability and timely discharge plans.
Daily monitors progress toward discharge plans and may alter plans due to patient condition or family needs, prioritizing patients at highest risk for complications, admission and readmission.
Educates patients and families with chronic illness about evidence‑based standards of care including self‑management strategies.
Identifies support needs for patients/families, develops action plans and provides guidance in initiating and overcoming self‑management strategies.
Ensures patients have access to prescriptions, durable medical equipment (DME) and other services as identified.
Contributes to problem solving within the team through communication, collaboration, data collection, obtaining consensus and evaluating outcomes of treatment options, tracking patient progress toward care plan goals and revising the care plan as indicated.
Advocates for patients to optimize health care needs including safety, physical, legal and financial well‑being.
Refers patients for education regarding health care delivery, reimbursement systems, prescription drug programs, health & wellness programs, community agencies, housing options and other services as appropriate.
Works with available IT resources (Phytel, Crimson) to facilitate registry reporting and maintenance of specified patient populations to improve disease outcome measures through evidence‑based guidelines and clinical decision support tools, referral and test tracking and preventive medicine reminders.
Participates in clinical outcome measurement to identify strategies that promote population health.
Ensures patient safety in performing job functions supporting policies, procedures and standards.
Maintains regular, punctual attendance consistent with Orlando Health policies, ADA, FMLA and other standards.
Maintains compliance with all Orlando Health policies and procedures.
Qualifications
Master’s degree from an accredited school of Social Work, Mental Health, Psychology or Marriage and Family Therapy is required.
Handle with Care (HWC) Certification is required for Behavioral Health Unit.
Two (2) years of direct clinical experience with emphasis on the population to be served in the assigned area. Successful completion of Master’s level internship within the population may substitute for two (2) years of experience.
#J-18808-Ljbffr