Job Summary

This position develops, coordinates and provides social work services to patients and families who are faced with social, emotional and situational stressors precipitated by illness, injury, and/or disability. The goal is to aid in adaptation and empower the patient and the family to participate to the fullest of their abilities in the discharge planning process. This position provides developmentally appropriate care for the population that it serves which includes planning for the safe discharge and continuity of care, the ability to recognize and plan for the unique needs of all ages as well as the physically disabled, mentally ill, chronically ill and terminally ill patient.

Essential Functions

• Processes and facilitates the assessment with analysis of functional and psychological needs of the patient within the framework of his/her developmental stage, functional abilities, cultural milieu, and support network. Assessment of the relationship of the patient's medical needs to the patient's home situation, financial resources, and availability of community resources. Assessment of the social and emotional factors related to the patient's illness, need for care, response to treatment, and adjustment to care. Assessment includes: initial assessments, behavioral observations, test (MMSE, depression screening, substance abuse screening), resource identification - strength based, collection and analysis of information to determine an individuals treatment needs.

• Formulates a plan of intervention acceptable to the patient, family, and health care team. Facilitate adjustments to the plan of care when necessary to promote enhanced outcomes. Collaborates with all members of the healthcare team to develop, manage, and communicate patient needs and discharge plans.

• Documents all interventions in the patient medical record both timely and accurately including all elements of the transitional care plan to include the discharge plan.

• Provides advocacy, assistance, support, counseling and crisis intervention to patients and families. Facilitates hospital-sponsored support groups.

• Functions in a liaison role between the hospital and community in making community resources available to the patient and family.

• Maintains knowledge of Medicare, Medicaid and other program benefits to assist patients with discharge planning and choices. Knowledge of contemporary behavioral health and system theories relevant to health care, end of life dynamics, and interventions; grief and bereavement counseling, substance abuse identification and interventions, support of victims of abuse, neglect, or violence. Provides professional education to staff and community.

• Gather / assessing information, apply counseling and developmental theories, utilizing diagnostic frameworks, and engage in collaborative treatment planning.

Minimum Qualifications

Requires a Masters Degree in Social Work, Counseling or related field.

Requires a Licensed Master Social Worker (LMSW) (equivalent*) or Licensed Clinical Social Worker (LCSW). An equivalent license applies to states that do not recognize an LMSW; therefore, the employee must possess a Masters Degree and be a Licensed Social Worker. For assignments in an acute care setting, Basic Life Support (BLS) certification is also required.

Requires a proficiency level typically achieved with three years acute care hospital experience. Banner Registry and Travel positions require a minimum of one year experience in an acute care hospital setting. Experience must include working in an acute care setting within the past 12 months as a Social Worker MSW in the specialty area.

Must have knowledge of government/community resources such as Medicare, Medicaid, long-term care or any other applicable resources/services. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, human relations skills and time management skills. In acute care, must be able to work flexible hours and take rotating call after hours.

Preferred Qualifications

Additional related education and/or experience preferred.