Social Worker (LSW Required) in Normal, IL at Carle Health System

Date Posted: 4/4/2021

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Normal, IL
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    4/4/2021

Job Description

Position Summary:
To provide consultant capacity within the multidisciplinary care team, facilitating psychosocial screening, collaborating with care teams to manage patients psychosocial and behavioral health issues. Utilize Milliman/Interqual/Midas to assist with establishing clinical criteria for admission, treatment, and discharge.

Qualifications:
EDUCATIONAL REQUIREMENTS
Bachelor's or Master's in SW (LSW, LCSW or LCPC) or related degree

CERTIFICATION & LICENSURE REQUIREMENTS
LSW, LCSW or LCPC

EXPERIENCE REQUIREMENTS
Two (2) years of related experience preferred

OTHER REQUIREMENTS
Ability to problem solve and develop solutions for patients and their families. Strong knowledge of available community resources. Awareness of when and how to access additional resources to meet the needs of patients. Strong communication skills. Strong advocacy skills necessary.

Essential Functions:

  • Utilize Milliman (Interqual) criteria to assist with establishing clinical criteria for admission, to monitor clinical progression, to evaluate criteria for continued stay, and to establish an anticipated discharge date
  • Contact insurance companies and provides required information to obtain Medicaid or insurance authorization for admission, complete continued stay reviews, or obtain authorization for services
  • Records required information to track pertinent patient information, IE:  MIDAS, Meditech, Epic, and appropriate referral software programs
  • Performs preauthorization related to admission needs
  • Assists with denial notifications and the appeal process
  • Works with hospital case management to assist with challenges related to discharge to assure the best outcome for patients
  • Initial authorizations for Addiction Recovery In Patients, Intensive Out Patients, Partial Hospitalization Patients, and Continuing Care Patients
  • Initial authorizations for Mental Health In Patients
  • Concurrent reviews
  • Discharge reviews
  • Compliance with industry guidelines, regulatory agency requirements, corporate policies and procedures is mandatory.  Standards for the quality of work performed are high for the incumbent. 

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.