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Primary City/State:

Phoenix, Arizona

Department Name:

Utilization Mgmt

Work Shift:

Day

Job Category:

General Operations

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN.

The Integrated Care Team supports Utilization Management with challenging discharge planning for BPN members. Our departmental staff assist members to receive their care at the “right place” and the “right time”.

UM ICT Social Workers collaborate with our members and the entire healthcare team to aid in smooth transitions through the continuum of care. Our partnership with community and healthcare entities enable us to assist our members to reduce avoidable readmissions, strengthen discharge planning efficiencies and act as trusted stewards of our valuable healthcare resources.

Schedule Monday - Friday 8am - 4:30pm

Hybrid / Remote Must Reside in Arizona

Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY

This position develops, coordinates and provides social work services to patients and families who are faced with social, emotional and situational stressors precipitated by illness, injury, and/or disability. The goal is to aid in adaptation and empower the patient and the family to participate to the fullest of their abilities in the discharge planning process. This position provides developmentally appropriate care for the population that it serves which includes planning for the safe discharge and continuity of care, the ability to recognize and plan for the unique needs of all ages as well as the physically disabled, mentally ill, chronically ill and terminally ill patient.

CORE FUNCTIONS

1. Processes and facilitates the assessment with analysis of functional and psychological needs of the patient within the framework of his/her developmental stage, functional abilities, cultural milieu, and support network. Assessment of the relationship of the patient's medical needs to the patient's home situation, financial resources, and availability of community resources. Assessment of the social and emotional factors related to the patient's illness, need for care, response to treatment, and adjustment to care. Assessment includes: initial assessments, behavioral observations, test (MMSE, depression screening, substance abuse screening), resource identification - strength based, collection and analysis of information to determine an individual’s treatment needs.

2. Formulates a plan of intervention acceptable to the patient, family, and health care team. Facilitate adjustments to the plan of care when necessary to promote enhanced outcomes. Collaborates with all members of the healthcare team to develop, manage, and communicate patient needs and discharge plans.

3. Documents all interventions in the patient medical record both timely and accurately including all elements of the transitional care plan to include the discharge plan.

4. Provides advocacy, assistance, support, counseling and crisis intervention to patients and families. Facilitates hospital-sponsored support groups.

5. Functions in a liaison role between the hospital and community in making community resources available to the patient and family.

6. Maintains knowledge of Medicare, Medicaid and other program benefits to assist patients with discharge planning and choices. Knowledge of contemporary behavioral health and system theories relevant to health care, end of life dynamics, and interventions; grief and bereavement counseling, substance abuse identification and interventions, support of victims of abuse, neglect, or violence. Provides professional education to staff and community.

7. Gather / assessing information, apply counseling and developmental theories, utilizing diagnostic frameworks, and engage in collaborative treatment planning.

8. Has freedom to determine how to best accomplish functions within established procedures. Confers with supervisor on any unusual situations. Positions are facility based with no budgetary responsibility. Internal customers: All levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External Customers: Home health agencies, nursing homes, insurance providers, volunteer services, county and governmental agencies and medical supply companies.

MINIMUM QUALIFICATIONS

Requires a Master’s Degree in Social Work, Counseling or related field (requirement is based on business need and regulatory compliance, all positions may not have this requirement).

Requires a Licensed Master Social Worker (LMSW) (equivalent*) or Licensed Clinical Social Worker (LCSW) or have a MSW with the requirement to become licensed within 6 months of hire date. An equivalent license applies to states that do not recognize an LMSW; therefore, the employee must possess a Master’s Degree and be a Licensed Social Worker. For assignments in an acute care setting, Basic Life Support (BLS) certification is also required.

Requires a proficiency level typically achieved with 3 years acute care hospital experience. Banner Registry and Travel positions require a minimum of one year experience in an acute care hospital setting. Experience must include working in an acute care setting within the past 12 months as a Social Worker MSW in the specialty area.

Must have knowledge of government/community resources such as Medicare, Medicaid, long-term care or any other applicable resources/services. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, human relations skills and time management skills. In acute care, must be able to work flexible hours and take rotating call after hours.

PREFERRED QUALIFICATIONS

Additional related education and/or experience preferred.

EEO Statement:

EEO/Disabled/Veterans (https://www.bannerhealth.com/careers/eeo)

Our organization supports a drug-free work environment.

Privacy Policy:

Privacy Policy (https://www.bannerhealth.com/about/legal-notices/privacy)

EOE/Female/Minority/Disability/Veterans

Banner Health supports a drug-free work environment.

Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability