Medical Social Worker

POSITION SUMMARY:

The Medical Social Worker responsibility is to Provide psychosocial assessments of patients and families to identify emotional, social, and environmental strengths and problems related to their diagnosis, illness, treatment, and /or life situation. Formulate, develop, and implement a plan utilizing appropriates social work interventions. Collaborate with the health care team and involve the patient/family in the development and implementation of plans. Facilitate discharge planning across a multidisciplinary care continuum which includes interacting with consulting physicians, third party payer and other health care providers to facilitate movement of the patient through the system and arrangement of an appropriate care planning as well as discharge planning. Provide education and interventions to patients and families to enhance or restore the capacity for social functioning Works within the framework of the State Association of Social Work Board and follows all Integrity Hearts policies and procedures. Works under the oversight of the RN Clinical Director or his/her designee.

The Medical Social Worker will be tasked with maintaining working knowledge of and liaison with community agencies; provide information about and linkages to appropriate community services; participate in area activities related to health and social services as appropriate patients with their medical team and ensuring patients safely transition back to their community after discharge leadership within the home care domain. This position will report to the RN Clinical Director to ensure expectations are clear about the role and responsibilities.

ESSENTIAL JOB FUNCTIONS:

· Must possess knowledge of Integrity Hearts Health Services and social work policies and procedures and techniques

· 24/7 communication access for network of continuum services

· Align patients with short and long-term resources to manage holistic needs

· Manage distinct populations via clinical data descriptors

· Screen, address, and manage social determinants of health

· Make referrals and/or set up initial appointments

· Ability to apply critical thinking to physical, psychosocial, environmental, mental, cultural, family, and safety issues.

· Ability to practice as an effective member of an interdisciplinary team.

· The medical social worker administers social services to patients requiring intermittent professional services and teaches the patient, family, and other members of the health care team. These services are performed in accordance with the physician’s orders and the established plan of care.

· Making home visits to clients in designated geographic territories.

· Assist our team in understanding the social and emotional factors related to our clients’ health problems.

· Provide clinical social evaluations and plan appropriate interventions based on evaluation findings.

·Participate in the development of the total plan of care with the multidisciplinary as appropriate.

· Develop and maintain contracts with public and private agencies as resources for the patient.

· Educate and instruct patients, family members, or other patient representatives in community resources to promote the patient's health, safety, well-being, and independent living.

· Identify appropriate community resource referrals to address the client’s and the family’s practical and environmental needs.

· Act as an advocate for both the client and the family to navigate the patient through the community system such as: ineffective patient/family coping and decision making, advance directives long term or assisted living placement substance abuse abuse/neglect and/or bereavement in a safe manner consistent with the State of Practice and Integrity Hearts policies and procedures

· Maintain documentation in patient’s record per internal regulatory and professional standards.

· Monitor, observe, and evaluate changes and progress in patient’s condition and environment.

· Report changes, progress, or lack of progress to physician, Clinical Nurse Director and/or nurse case manager

· Able to speak, write, read, and comprehend English

· Strong interpersonal sills

· Ability to travel to cases, as assigned

EDUCATION:

· Graduate of an accredited Bachelors/Master of Social Work Degree from a Council on Social Work Education

· A minimum of one year of clinical experience is preferred

LICENSING & CERTIFICATION:

· Current bachelor’s in social work from CSWE accredited school of social work Licensure in good standing in state where services are performed.

· Current Master of Social Work from an accredited school of social work. Licensure in good standing in state where services are performed.

· Possess a valid state driver’s license or valid identification card and automobile liability insurance if applicable

PHYSICAL REQUIREMENTS:

· Lifting less than 20 lbs

· Prolonged standing

· Prolonged sitting

· Frequent bending

· Frequent walking

· Reaching (overhead, extensive repetitive)

MENTAL/SENSORY:

· Strong recall

· Reasoning

· Problem solving

· Hearing

· Effective communication

· Write legibly.

· Reading

· Logical thinking

EMOTIONAL:

· Face paced environment

· Steady pace

· Multitasking

· Ability to adapt to change

· Frequent customer/family interactions

This not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation