Discharge Planner (PRN)

Description

PURPOSE STATEMENT

Provide individuals, families, and groups with the psychosocial support needed to cope with chronic, acute, or terminal illnesses. Services include advising family caregivers. Provide patients with information and counseling and make referrals for other services. May also provide case and care management or interventions designed to promote health, prevent disease, and address barriers to access to healthcare.

ESSENTIAL FUNCTIONS

• Collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs.
• Advocate for clients or patients to resolve crises.
• Refer patient, client, or family to community resources to assist in recovery from mental or physical illness and to provide access to services such as financial assistance, legal aid, housing, job placement or education.
• Investigate child abuse or neglect cases and take authorized protective action when necessary.
• Counsel clients and patients in individual and group sessions to help them overcome dependencies, recover from illness, and adjust to life.
• Facilitate and delegate planning for discharge from care facility to home or other care facility.
• Monitor, evaluate, and record client progress according to measurable goals described in treatment and care plan.
• Modify treatment plans to comply with changes in clients' status.
• Identify environmental impediments to client or patient progress through interviews and review of patient records.
• Organize support groups or counsel family members to assist them in understanding, dealing with, and supporting the client or patient.
• Utilize consultation data and social work experience to plan and coordinate client or patient care and rehabilitation, following through to ensure service efficacy.
• Plan and conduct programs to combat social problems, prevent substance abuse, or improve community health and counseling services.
• Supervise and direct other workers providing services to clients or patients.
• Oversee Medicaid- and Medicare-related paperwork and recordkeeping in hospitals.
• Develop or advise on social policy and assist in community development.
• Perform other essential duties as assigned.

Requirements

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS

• High school diploma or equivalent.
• Bachelor's in Social Work.
• Collaborate with other professionals to evaluate patients' medical or physical condition and to assess client needs.
• Advocate for clients or patients to resolve crises.
• Refer patient, client, or family to community resources to assist in recovery from mental or physical illness and to provide access to services such as financial assistance, legal aid, housing, job placement or education.
• Investigate child abuse or neglect cases and take authorized protective action when necessary.
• Counsel clients and patients in individual and group sessions to help them overcome dependencies, recover from illness, and adjust to life.
• Plan discharge from care facility to home or other care facility.
• Monitor, evaluate, and record client progress according to measurable goals described in treatment and care plan.
• Modify treatment plans to comply with changes in clients' status.
• Identify environmental impediments to client or patient progress through interviews and review of patient records.
• Organize support groups or counsel family members to assist them in understanding, dealing with, and supporting the client or patient.
• Utilize consultation data and social work experience to plan and coordinate client or patient care and rehabilitation, following through to ensure service efficacy.
• Plan and conduct programs to combat social problems, prevent substance abuse, or improve community health and counseling services.
• Supervise and direct other workers providing services to clients or patients.
• Oversee Medicaid- and Medicare-related paperwork and recordkeeping in hospitals.
• Develop or advise on social policy and assist in community development.
• Conduct social research to advance knowledge in the social work field.
• Must be self-motivated and have the ability to work within the established policies, procedures and practices prescribed by the hospital/clinic.

PHYSICAL/MENTAL REQUIREMENTS

• Must be able to sit and stand, intermittent 8 to 10 hours a day.
• Must be able to use standard office equipment, including the telephone and computer keyboard.
• Continuously works under pressure of near 100% accuracy while meeting inflexible deadlines.
• Continuously utilizes manual/bi-manual dexterity, near vision, speech, and hearing.
• Frequently stands, walks, sits and utilizes eye/hand coordination and color definition.
• Occasionally reaches above shoulder, regularly required to life and/or carry up to 40 lbs.
• Occasionally walks on uneven surfaces.