• Masters in Social Work Required
• LCSW - Licensed Clinical Social Worker Required
• LICSW - Strongly Preferred
• 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

Pay quotes are an estimate of gross weekly pay, including non-taxable reimbursements, based on available information and subject to confirmation.

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