Description
LCSW Licensed Clinical Social Worker Required/ LISCW Licensed INDEPENDENT Clinical Social Worker Strongly Preferred. Masters in Social Work Required. 3+ years clinical experience in acute care in areas such as internal medicine, surgery, orthopedics, mother/child, cardiology, oncology, psychiatry. 3+ years clinical experience in Rehab Setting, Home Health and Long-Term Care would be considered. Ability to perform a comprehensive admission and discharge risk assessment related to quality, financial, payer benefit allowances and limitations, risk management and patient satisfaction. Experience specializing in utilization management (levels of care knowledge and demonstrable competence with evidence based criteria tools), discharge planning to entities throughout a continuum of care, previous care management or third party insurance review preferred. Current knowledge of CMS (levels of care determinations), appeal rights & DPH regulations required. Current knowledge of Kepro QIO (appeals) required. Knowledge of regulatory and accreditation organizations such as Joint Commission, DPH and HealthGrades preferred.
