Social Worker- Bachelors- Full-time

Social Worker- Full-time, 40hrs/wk, days

Qualifications:

Minimum Education: 

Bachelors of Social Work, Psychology, or Counseling.

Minimum Experience: 

At least one year experience providing Medical Social Work services, and discharge planning.

Basic computer skills.

Minimum skills/abilities:

• Requires excellent organizational and communication skills in the English language, and preferably in a second language.
• The ability to deal with a rapidly changing health care environment and requires excellent interdisciplinary team collaboration skills.
• Evidence of continuing professional development.
• Ability to identify trends and make connections between care patterns.
• Ability to critically think.

Position Function: 

The Social Worker in the Care Management Department works effectively under the direction of a clinical supervisor to coordinate discharge planning activities in cases requiring short and long term placement. 

Assists patients and their families in coping with illness and resolving complex predisposed or incurred, emotional, financial, and environmental difficulties which interfere with obtaining maximum benefits from medical care. 

Provides consultation with the support of a clinical supervisor to medical and paramedical personnel regarding impact of psychosocial factors on patient illness.

Job Relationships: 

Supervised and/or reportable to the following by job category:

     -  Director of Care Management

     -  Clinical Supervisor

     -  Member of Care Management Team.

     -  Collaborates with the Care Manager.

Collaborates with the following staff:

     -  Physicians

     -  House Staff

     -  Nursing Staff

     -  Physical Therapy

     -  Respiratory Therapy

     -  Mental Health Workers

     -  All Departments within the Medical Center

Demonstrates knowledge of assessing patients and families through psychosocial assessment processes and determining psychological social and environmental needs. 

Demonstrates knowledge of developing appropriate plans for treatment and assistance, including a thorough review of the medical records and other relevant documentation and interviews with physicians, health care team, family and involved community agencies.

Authority: 

Has the authority and responsibility to providing the following services under the direction of a clinical supervisor:

     -  Collaborate with the Care Manager to plan the delivery of patient care across the continuum

        and in the collaboration with the health care team.

     -  Collaborate the transition of patient along the continuum, from pre-admission to discharge

        with follow-up post discharge in selected situations.

     -  Conduct family meeting to communicate the discharge plan and to provide support/education

        as needed.

     -  Evaluate and report clinical, quality, and utilization outcomes.

     -  Serves as member of the collaborative group practice.

     -  Provides consultation to nursing staff on social issues.

Responsibilities/Essential Functions:        

1.) "Provides superior customer service to internal and external clients, customers, and patients as referenced in the Service Excellence Standards."         

• Demonstrates excellence in the delivery of patient care services through participation in the clinical programs facilitated by the Care Management and Social Work Services team.
• Effectively coordinates discharge planning activity in cases requiring social work/Care Management team intervention under the direction of a clinical supervisor. 
• Acts as case manager under the direction of a supervisor, mobilizing and monitoring all adjunct activities necessary to effect appropriate discharge plans, including securing appropriate financial resources, and supporting patients and families through clarification and communication of the discharge planning process.
• Provides consultation to physicians, health care team, and other professionals by providing essential psychosocial information diagnostic formulations, plans and treatment recommendations. 
• Participates in team meetings and coordinates patient care meetings with in-house and outside agencies.
• Is able to devise efficient methods and systems for accomplishing tasks associated with Social Work Services; maximizes time utilization and efficiency; institutes changes in techniques and procedures as required.
• Supports department policies, procedures and practices for documentation and providing high quality care, to ensure compliance with the guidelines of the J.C.A.H.O, the Department of Public Health, and other regulatory agencies as required.
• Adheres to strict confidentiality guidelines regarding patient information or interdepartmental and intradepartmental matters.
• Thoroughly reviews patient charts (as applicable) and always documents services in a neat and complete manner.
• Consistently combines ethical judgment with professional skills within the policy and legal framework of the institution; understands the legal, social, economic and political forces which have been brought to bear upon the current health care system and community.
• Develops discharge plans based upon functional assessment in collaboration with patient, family, physician and health care team.
• Implements discharge plans and arranges for appropriate post-hospital care by referring patients to appropriate transfer facilities or home health/home care agencies under the supervision of a clinical supervisor.
• Evaluates community resources for quality and appropriateness and develops and maintains referral and transfer relationships.
• Completes department statistical reports, agency specific referral forms, and other required documents from regulatory programs.
• Completes Medicare and other application forms as is appropriate.
• Provides information/referral services.
• Provides consultation to Interdisciplinary Team.
• Accesses patient demographic information.
• Participates on committees as assigned regarding patient care issues/service enhancement.
• Establishes and maintains appropriate interpersonal relationships with patients, visitors, and other hospital personnel, while ensuring confidentiality of patient information.
• Assists in Quality Improvement initiatives as assigned.
• Responsible for service and operational excellence of all assigned department activities to ensure the delivery of quality services and/or outcomes required to meet or exceed the expectations of those utilizing or impacted by the department.
• Completes progress notes in a timely manner clearly specifying status of plan under the supervision of a clinical supervisor.
• Properly uses office equipment.
• Assists in monitoring utilizing of supplies.
• Assists in maintaining a safe working environment.
• Demonstrates the role of Medical Social Worker in a professional manner.
• Assumes accountability for his/her position and patients (ex. extends self when unusual need arises).
• Performs other duties as assigned.
• Reports for work on time and gives adequate notice of absenteeism of tardiness.
• Routinely undertakes additional tasks when his/her assignment is completed. 
• Accepts constructive criticism regarding own performance and strives to make improvements.
• Adheres to policies established for meals, breaks, dress code, and parking.
• Exhibits courtesy, compassion, and respect to patients, families, visitors, physicians and co-workers.

Maintains competencies through:

     -  Regular participation in continuing education program.

     -  Demonstrates understanding of fire, disaster plan, and infection control policies.

Motivated and self-directed:

     -  Carries out responsibilities promptly and in a self-directed fashion.

     -  Seeks additional learning experiences. 

Responsibilities/Non-Essential Functions:             

Reporting Requirements: 

Reports all changes involving the coordination of patient's plan of care to the appropriate health care team member either verbally or in writing.

Reports promptly to the Director, Care Management and Utilization and other appropriate individuals, (as determined by the Care Manager), any deviation in normal operations, or any potential problems which may significantly alter/effect quality initiatives such as clinical standards and L.O.S.

Provides weekly and monthly reports to Director, Care Management and Utilization.           

Accountability: 

• Shall be accountable for the maintenance of a care manager system for their assigned service line/types, including discharge utilization, care management under the direction f a clinical supervisor.
• Shall be accountable to assess 100% of the patients in case type assignment under the direction f a clinical supervisor.
• Shall be accountable to clinical supervisor to follow-up the assessment process with care planning, intervention and evaluation (in appropriate patients) consistent with the clinical guidelines.
• Shall be accountable under the direction of a clinical supervisor to document care management activities according to policy.
• Shall be accountable for maintaining the confidentiality, and security of all
  Medical Center related, medical staff related and all sources of patient data information.
• Shall be accountable for abiding by all relevant
  Medical Center policies and procedures.
• Shall be accountable under the direction of a clinical supervisor for the transition of St. Elizabeth's patients across the continuum as defined by each Care Manager's individual assignment.
• Shall be accountable for the identification, measurement, interpretation and reporting of trends along their patient care continuum.
• Shall be accountable for specific outcomes for their practice which belong to the Care Manager's domain of their role (i.e., clinical, quality, and financial).
• Shall be accounting for self-learning activities including maintenance of advances in the area of care management as well as pay or utilization updates.
• Shall be accountable for appropriately using the computer systems for their support and expansion of the data collection/analysis process.
• Shall be accountable for participating in quality improvement activities focusing on and derived from the Care Manager's practice.
• Shall be accountable for implementation of leadership skills within own clinical practice, Collaborative Group Practice, peers and colleagues.
• Shall be accountable for the maintenance of the CareMap.

Steward Health Care is proud to be a minority, physician owned organization. Diversity, equity, inclusion and belonging are at the foundation of the care we provide, the community services we support and all our employment practices. We do not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.