The Medical Social Worker assesses patients of all ages potentially at high risk for social, emotional, mental/behavioral, and medical complications and assists them in exploring choices available to them, the goal being to reach an optimal level of independent functioning through the acceptance/modification of their social, emotional/behavioral and medical status. Responsible for psycho-social assessments for patient of all ages in all areas of the hospital. Responsible for discharge planning.

Primary responsibilities include working closely with interdisciplinary team to determine patients’ needs and coordinate care needed after discharge from hospital. Meet with patients and families to determine level of assistance that can be provided at home after discharge and make referrals to home health, skilled nursing facilities, assisted living, long-term care or hospice facilities. Connects patients with community resources to assist patient at home. Plan and attend family meetings with patient and medical/therapy team. Maintains and fosters relationships with resource partners, DHHS, regulators, and community leaders. Eliminates barriers to the patient’s good health and social concerns to decrease re-admissions.

Status: Full time

Qualities: Requires excellent interpersonal and organizational skills and the need to be a team player interacting with community facilities and agencies as well as disciplines in a fast-paced critical access hospital.

Requirements: Maine LSW license required. Knowledge of community resources helpful. Experience in medical social work preferred.