Employment Type : Full-Time
Position Requirements:
Masters degree of Social Work from an accredited school Has demonstrated time management, organization and documentation skills
Demonstrated understanding of medical terminology, developmental stages and psychosocial treatment
Demonstrated solid communication skills and collaboration with the interdisciplinary team LSW or eligible (if eligible, must obtain within one year of employment) Ability to handle crisis situations
Weekend, holiday and evening coverage as per site requirements
Resiliency and flexibility to effectively work within a constantly changing health~care environment
Demonstrated problem~solving ability
Fast paced work environment with established time constraints
Ability to handle multiple tasks and complete work within short timeframes
May be exposed to hazardous materials and life threatening diseases
Knowledge of universal precautions
Is customer and service focused
Purpose:
To provide professional discharge planning services through assessments, and coordination of post hospital care needs to patients and their families. Provides resources and choices to families to effectively link them to the needed level of emotional, medical and spiritual care.
This role will receive referrals for individuals from at~risk populations from interdisciplinary team members (including physicians, Care Managers, staff nurses and other members of the care team). Participates as an active member of multi~disciplinary team.
Accountabilities:
Engages in Performance Improvement and patient safety initiatives.
Complex Discharge Planning based on assessment of patient and family needs, preferences and available resources in order to ensure a timely discharge and to provide appropriate linkage with post~discharge care providers( i.e. New/Resumptions SNF, LTAC, Rehab, Dialysis, Hospice, DME and Home Health etc. )
Psychosocial Assessment and Interventions on the basis of preliminary risk screening, assesses patients and family's psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope. Supportive counseling and clinical Social Work intervention for patients and families in acute emotional distress.
Accountable for site specific KRA goal achievement as it relates to Care Coordination across the continuum.
Maintenance of professional standards and responsibilities for his/her own professional practice according to accreditation, hospital, system, state and NASW Standards and Code of Ethics.
Functions as a member of the interdisciplinary team, sharing expertise to assist in the diagnostic and treatment planning process.
Completion of an assessment/history on all identified patients within appropriate time frames.