As the region's only Level I Trauma center, Harborview Medical Center (HMC) is well known for innovations and excellence in trauma care and its centers of emphasis: Trauma, Burn, Neurosciences, AIDS/STD, Center for Advanced Reconstruction and Rehabilitation (CARER), and mentally-and medically- vulnerable populations. In addition to the centers of emphasis, HMC serves a mission population for King County. Harborview employees are committed to the vital role the institution plays in the immediate community, as well as the entire Northwest region. HMC is owned by King County and managed by the University of Washington (UW) and serves as a training site for UW’s School of Medicine. The UW is proud to be one of the nation’s premier educational and research institutions. Our people are the most important asset in our pursuit of achieving excellence in education, research, and community service. Our staff not only enjoys outstanding benefits and professional growth opportunities, but also an environment noted for diversity, community involvement, intellectual excitement, artistic pursuits, and natural beauty.
Harborview Medical Center has an outstanding opportunity for a full-time, day shift, MEDICAL SOCIAL WORKER. The individual in this position will provide direct social work services and provide support to Psychiatric Utilization Management.
RESPONSIBILITIES:
Responsible for ongoing review of a group of psychiatric patients including the identification of reason for admission, clinical complications and relevant co-morbidities
Provide regular reporting of clinical information to relevant payers as required to obtain ongoing inpatient level of care certification for the patient and to decrease financial risk for the hospital
Monitor length of stay by performing admit, concurrent and retrospective reviews using Milliman or other criteria
Act as a resource/content expert on information regarding patient level of care, symptom severity, care intensity and funding to the inpatient multidisciplinary teams to help in decision making and efficient use of hospital resources
Interacts with external utilization review organizations or payers as directed by Social Work Supervisory for inpatient concurrent review approvals, keeps physicians, psychiatric social workers and other clinical care providers informed when there are issues that may impact ongoing inpatient level of care
Review patient records for proper case documentation, and medical necessity of treatment in relation to federal, state and county regulations
Facilitate improved team documentation in medical records to ensure clinical acuity is documented appropriately and supports patients’ level of care needs while mitigating financial risk to the medical center
Serve as an ambassador for the Social Work Department and promote effective working relationships within assigned service area and multidisciplinary team, including but not limited to providing colleagues with clinical consultation in area of expertise and demonstrating leadership in complex utilization management cases
Develop and maintain working knowledge of medical conditions, treatments and plans of care pertaining to assigned service area
Document according to practice area guidelines
Ensure work queue documents are maintained and accurate so reviews are completed on time and to allow for coverage staff to maintain necessary work while out of the office
Comply with all aspects of HIPAA regulations
Participates in Quality Improvement studies, to continually evaluate the program effectiveness and ability in promoting quality driven, cost effective achievable goals and outcomes for our members
Mentor new staff and serve as a Practicum Instructor for Social Work students, as assigned
Actively participate in the development of yearly performance goals and implementation plan
Attend and participate in supervision and departmental meetings, including Grand Rounds, team meetings and committees as assigned
Identify and attend educational seminars which enhance job performance
Participate in data collection and quality improvement activities as assigned
Complete payroll documentation and leave requests in a timely manner
Proactively comply with departmental and hospital-wide initiatives, including HMC competencies, departmental competencies, and vaccination/infection control campaigns
Participate in (weekly/monthly) LOS and Psych UM meetings
REQUIREMENTS:
A Master of Social Work Degree from a program accredited by the Council on Social Work Education
AND
One year of full-time social work experience in a health care setting or equivalent. Experience can include a practicum placement as part of a social work training program and/or employment experience.
DESIRED:
Three years of full-time clinical social work experience in a behavioral health-care setting
Two years of inpatient behavioral health utilization management experience
Experience with the DSM-V, utilization management to include concurrent reviews, appeals and denials
LEGAL REQUIREMENT:
Licensed as an Independent Clinical Social Worker by the State of Washington within 90 days of employment.
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