Job Description

Care Transition Manager Social Worker LMSW/LCSW
PRN
Bring your passion to Texas Health so we are Better + Together
Work location: Texas Health Ft. Worth, 1301 Pennsylvania Avenue, Ft. Worth, TX 76104
Care Transition Management department

• Work hours: PRN, mainly weekdays between 7:30AM-5:00PM, on an as needed basis, Weekends are optional; During training, hours will vary between 7:30AM-5:30PM
• (***Does Require 5-weeks of training Monday to Friday***)

Care Transition Management department highlights:
Supporting the 815-bed, Magnet-designated, full-service hospital that has served the Ft. Worth and surrounding community since 1930
Care Transition is a rewarding career with family-friendly hours
Here's What You Need
Master's Degree Social Work Required (Individuals hired as a CTSW prior to May 11, 2017, will be grandfathered to the CTSW position with BSW, at the entity they were employed at on May 11, 2017)
3 Years' experience in hospital/medical social work Preferred
1 Year discharge planning/care management Preferred
LMSW - Licensed Master Social Worker Upon Hire Required Or
LCSW - Licensed Clinical Social Worker Upon Hire Required
CPR - Cardiopulmonary Resuscitation Upon Hire Required
ACM - Accredited Case Manager Upon Hire Preferred
CCM - Certified Case Manager Upon Hire Preferred Or
Other ANCC Upon Hire Preferred
What You Will Do

• Working knowledge of medical necessity criteria preferred

• Knowledge of Microsoft Outlook and Office (Word, Excel)

• Customer service skills

• Ability to engage in complex clinical decision-making and discharge planning

• Strong oral and written communication skills

• Strong commitment to interdisciplinary collaboration

• Critical thinking, analysis and conflict resolution skills

• Psychosocial and crisis intervention skills

• Ability to prioritize and meet deadlines

• Identify community resources and service needs and facilitate appropriate referrals as needed.

• Responsible for ensuring patients are transitioned to appropriate levels of care in a timely and effective manner.

• Reviews the Texas Health Readmission Indicator List (THRIL) scores daily for all assigned patients and collaborates with the interdisciplinary team to identify high risk patients whose THRIL score may not have indicated appropriately.

• Promotes discussion and assists in the identification of a primary care physician (PCP) for patients without a PCP

• Completes Transition Evaluations on patients within 24 hours of identification and begins discharge planning

Additional perks of being a Texas Health Social Worker
Benefits include 401k, discounts in the cafeteria.
A supportive, team environment with outstanding opportunities for growth.
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Skills Required