Job Requirements:

• Master's Degree in Social Work or field of Human Services from an institution accredited by the Council Of Social Work Education as specific by JCAHO.
• One year Utilization Review experience.
• Requires knowledge of the discharge planning process, community resources and the networking process necessary to provide high-quality service to patients and their family, hospital staff and others seeking services, counseling techniques to the degree necessary to provide appropriate emotional support to patients, their families, hospital staff and the public, and the process of an interdisciplinary team approach to patient care.
• Requires the skills in obtaining information needed to compile an accurate, objective social history, empathetic listening, psycho-social assessment, problem solving and crisis intervention techniques.
• Requires skills in communication to facilitate an interactive team process in working with patients, clinical skills in counseling as demonstrated by experience and references, interpersonal skills in facilitating orientation and education sessions with management, union medical, supervisory personnel and employees.
• Requires the ability to assess patient/family needs to provide for quality service delivery, communicate effectively, and assess the need for follow up of certain patient/family/employee situations.
• Requires knowledge of current utilization review principles.
• Requires the ability to work independently, communicate verbally and in writing with all levels of clinical and administrative personnel, adapt to change and communicate changes in a supportive manner.

Job Duties:

• Promotes positive relations when interacting with patients, visitors, families, physicians, customers and co-workers.
• Discharge planning to include: responds to referral, assess situation, communicates actions taken verbally and in writing.
• Provides mandatory child abuse/neglect and adult abuse/neglect reports.
• Assists in the coordinator of Utilization Review activities.
• Performs admission review in order to asses the medical necessity of patient’s hospitalization, assure appropriate level of care and facilitate early discharge planning.
• Obtain and disseminate knowledge of community resources within the context of patient, family, and employee situational requirements.
• Obtains objective, informative social history in a timely manner.
• Provide counseling of patients and families.
• Provides group therapy to patients.
• Prepares a continued stay review. Using pre-established criteria review hospitalized patient records to determine appropriateness of continued stay.
• Acts as liaison between Jennie Edmundson Chaplaincy Corps and Hospital Administrator.
• Attends conferences and in-services as necessary.
• Provides completion of denial process as outlined in the utilization review plan and Medicare guidelines.
• In cooperation with physicians, conducts appeals with 3^rd party payors when benefits denied.
• Participates in on-going education for self, physicians and staff regarding Utilization management policies and Managed Care contracts.
• Participates in the development of an interdisciplinary evaluation program to improve patient care.
• Participates in the development and implementation of case management projects.

Applications may be submitted on line www.bestcare.org or to Jennie Edmundson Human Resources Office. We are located in Jennie Edmundson Hospital 933 E Pierce Street in Council Bluffs and are open Monday-Friday 8am-4:30pm.