Open To Work
ROSA PACIFICO
Licensed Social Work, Certified Case Manager
347 Hillside Ave, Springfield,NJ
Summary
Licensed social worker and certified case manager with over 17 years of experience in acute care, transitional care, and utilization review. Expertise in MSSP coordination and population health management. Proven track record in conducting comprehensive psychosocial assessments and optimizing discharge outcomes through effective case coordination. Strong advocate for patient needs, facilitating advance care planning and collaboration among multidisciplinary teams. Dedicated candidate eager to leverage knowledge in social services and program development. Skilled in running social services initiatives and developing policies and procedures. Collaborative and committed to addressing social issues to improve quality of life in marginalized communities.
Overview
17
17
years of professional experience
Work History
Social Work Case Manager
Summit Health
Berkeley Heights, USA
08.2019 - 05.2026
- Reduced hospital readmissions through proactive transitional care for high-risk patients, executing follow-up protocols within 48-72 hours and coordinating cross-continuum transitions.
- Identified and resolved critical care barriers for patients via comprehensive psychosocial assessments, addressing behavioral health needs and social determinants.
- Elevated patient engagement and self-management outcomes by providing evidence-based counseling and health literacy education, resulting in improvement in medication adherence.
- Advanced patient-centered care by facilitating advance care planning conversations, achieving seamless alignment with patient goals.
- Accelerated access to end-of-life services by coordinating hospice referrals, reducing time-to-service.
- Drove MSSP quality performance improvement by closing care gaps across key measures.
Senior Case Manager
Kessler Rehabilitation
West Orange, New Jersey
12.2006 - 08.2019
- Directed complex care coordination for patients with traumatic brain injuries, spinal cord injuries, strokes, amputations, and severe orthopedic trauma, accelerating recovery trajectories and reducing care fragmentation.
- Functioned as the central communication hub for patients, families, physicians, therapists, and external providers, eliminating barriers to care and improving patient satisfaction scores.
- Orchestrated end‑to‑end discharge planning, consistently achieving safe transitions to home, skilled nursing facilities, outpatient therapy, and community programs while minimizing readmission risk.
- Executed rigorous utilization reviews and secured timely authorizations through strategic collaboration with managed care organizations, protecting reimbursement integrity and ensuring full compliance with payer standards.
- Drove interdisciplinary collaboration to establish data‑driven, measurable treatment goals, resulting in more efficient care pathways and improved functional outcomes at discharge.
- Strengthened discharge‑to‑home rates through proactive advocacy, early identification of barriers, and comprehensive care planning that empowered patients and families.
Education
Bachelor of Arts - Psychology
Rutgers, The State University of New Jersey
New Brunswick, NJMaster of Social Work (MSW) - Clinical Social Work
Rutgers, The State University of New Jersey
Newark, NJSkills
- Crisis intervention
- Transitional and advance care planning
- Behavioral health support
- Outcome measurement and evaluation
- Resource allocation
- Problem solving and decision making
- Time management
- Utilization review
- Multidisciplinary collaboration
- Psychosocial assessment
- Patient advocacy
Affiliations
- National Association of Social Workers (NASW)
- Case Management Society of America (CMSA)
Certification
- Licensed Social Worker (LSW), New Jersey
- Certified Case Manager (CCM)
- Certified Advanced Care Planner
Work Preference
Job Search Status
Open to workWork Type
Full TimeLocation Preference
On-SiteRemoteHybridSalary Range
$94000/yr - $200000/yrTimeline
Social Work Case Manager
Summit Health
08.2019 - 05.2026
Senior Case Manager
Kessler Rehabilitation
12.2006 - 08.2019
Bachelor of Arts - Psychology
Rutgers, The State University of New Jersey
Master of Social Work (MSW) - Clinical Social Work
Rutgers, The State University of New Jersey
Continuing Education And Training
- Motivational Interviewing: Behavioral Change Strategies, 2023
- Trauma-Informed Care in Clinical Practice, 2026
- Cultural Competency & Health Equity in Care Transitions, 2024
- Grief Counseling & Family Support Dynamics, 2023
- Advanced care planning,2022