Social Worker LMSW - Care Management

JOB SUMMARY The Social Worker is responsible for creating outcomes for the patient and family by managing complex psychosocial and economic co-morbidities.
Provides education and consultation regarding resources, collaborates to develop a discharge plan and facilitates and monitors its implementation.
Assists patient/family adjust to and cope with illness, diagnosis, treatment options, and prognosis.
Through advanced practice skills mobilizes resources to reduce risk, serves as a liaison between the hospital and the community.
In addition, offers crisis interventions to patient/family.
Strives for superior performance by consistently providing a product of service to leadership and staff that is recognized as ultimately contributing to the patient and family experience.
As a customer-focused Memorial Healthcare team member, he/she must be accessible, flexible, knowledgeable, and responsive.
JOB RELATIONSHIPS RESPONSIBLE TO: Director of Hospital Throughput, Associate Manager of Social Work WORKERS SUPERVISED: None INTERRELATIONSHIPS: Case management department staff; other hospital departments; Medical staff; patients; families; external agencies PRIMARY JOB RESPONSIBILITIES Psychosocial Assessment and Interventions On the basis of preliminary risk screening, assesses patient and family psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness, and ability to cope.
Intervenes with patients and families regarding emotional, social and financial consequences of illness and/or disability; accesses and mobilizes family/community resources to meet identified needs.
Provides intervention in cases involving child abuse/neglect, domestic violence, elder abuse, institutional abuse, and sexual assault.
Serves as a resource person and provides counseling and intervention related to treatment decisions and end-of-life issues.
Discharge Planning Participates in discharge planning activities for complex patients in order to ensure a timely discharge and to provide appropriate linkage with post-discharge care providers.
Deals with families exhibiting complex family dynamics that impact directly on patient care and discharge.
Communicates with healthcare team regarding the discharge planning status of all patients referred by them.
Assists RN Case Managers or appropriate team members with discharge planning activities as requested.
Provides consultation to RN Case Manager or appropriate team members when coordination with significant or intensive community resources is necessary to achieve desired treatment outcomes.
Receives referrals for complex patient problem resolution from RN Case Managers or care team members.
Screens and coordinates referrals to the next level of care, SNF, LTAC, Hospice and Rehab.
Validates discharge criteria for patients and families and notifies RN Case Managers of newly-identified resources or change in previously-identified resources.
Educates patient/family and physician regarding post-acute options and addresses issues of choice.
Patient and Family Support in Legally Complex Cases Provides intervention in child abuse/neglect, domestic violence, guardianship (temporary/ permanent), foster care, adoption, mental health placement, advance directives, adult/elderly abuse, child protection, and sexual assault.
Ensures safe care to patients adhering to policies, procedures, and standards within budgetary specifications including time management, supply management, productivity, and accuracy of practice.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization.
Actively participates in care conferences and multidisciplinary rounds.
Advocates for patient and family empowerments and independence to make autonomous healthcare decisions and accesses needed services within the healthcare system.
Actively participates in clinical performance improvement activities as assigned.
May provide supervision of Social Worker interns, MSW’s with less than 4,000 hours of hospital experience ensuring requirements mandated by the State of Michigan.
Provides mentorship to all levels of Social Work in current social trends and practice.
Maintains documentation of the Case Work process in the patient’s medical record to include problem statement, plan, interventions, and outcomes.
Documents progress with active placement activities at least three (3) times per week.
Records case work volume statistics required by departmental leadership.
Arranges for and participates in coverage during short, long, and/or unexpected absences of self and other Case Management staff.
Demonstrates job related aspects of patient safety to assure a safe environment, safe and effective use of equipment and technology, and decreased risk of potential adverse patient occurrences.
Demonstrates knowledge of and supports hospital mission, vision, value statements, standards of care, policies and procedures, operating instructions, confidentiality statements, corporate compliance plan, standards of behavior, customer service standards, and the code of ethical behavior.
Must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of patients served on his/her assigned unit.
Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the unit's and division's policies and procedures.
Performs other specific duties as assigned.
JOB SPECIFICATIONS 1.
EDUCATION Masters prepared Social Worker with current licensure to practice medical social work in the state of Michigan (LMSW).
If LLMSW, must obtain LMSW designation within 12 months of qualification to sit for exam.
2.
EXPERIENCE Two (2) years experience in a short-term acute care hospital setting preferred.
Prior Case Management or health finance experience desirable.
Experiential knowledge of the post hospital placement process preferred.
3.
ESSENTIAL PHYSICAL REQUIREMENTS Travel independently within the hospital.
Access patients/families including in areas which are confined by space and/or equipment.
ESSENTIAL MENTAL ABILITIES Complete an assessment of the patient’s current medical status and develop an appropriate plan with identified discharge needs.
Work effectively in situations of high stress, interruptions and deadlines.
Read and interpret data from various sources.
Analyze data and set appropriate plan of action.
Accurately assess patient’s progress toward care goals and discharge readiness.
Self motivated and able to work independently.
5.
ESSENTIAL TECHNICAL/MOTOR SKILLS Communicate assessment finding and plan by written word.
Use hospital computers.
Create, send, and retrieve data from hospital information system.
Use telephone, fax, and other basic office equipment.
Proficient in Microsoft Word and Excel or be willing to obtain the appropriate skills.
6.
ESSENTIAL SENSORY REQUIREMENTS Communicate receptively and expressively in English, both written and verbal, with diverse populations, including physicians, patients, families, community agencies, employees, and volunteers.
Visually assess patient/family needs and assess readiness for discharge.
Accurately hear communication by phone or in person.
Maintain self control.
7.
INTERPERSONAL SKILLS Demonstrate excellent human relation skills through all forms of communication.
Interact effectively with patients, families, physicians, staff, and outside agencies to provide appropriate and complete patient care.
Interpersonal skills necessary to facilitate a group of employees.
Cope with stressful situations or encounters.
Manage multiple and sometimes conflicting priorities and work regularly with difficult medical/emotional/psychosocial problems.
Demonstrate flexibility with work schedule and covering for other team members.
Cope with a changing environment and identify opportunities for improvement.
Demonstrate a positive attitude.
Maintain a professional and courteous manner.
Maintain confidentiality.
8.
WORK CONDITIONS Work in the patient care environment.
Frequent walking, sitting and standing.
Regular lifting and carrying of items up to fifteen (15) pounds.
Location: Memorial Healthcare · Care/Case Management Schedule: Full Time, Days, 8am