Overview

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Job Summary

Provides crisis intervention and information/referral sources to patients and the patient's social support system. Works collaboratively with the Clinical Care Management team to effect positive patient and family outcomes and to ensure efficient utilization of resources.

Essential Functions

• Provides casework services to patients and patient's social support system for a designated patient population. Assists patients and patient's social support in dealing with issues related to hospitalization and disease processes.
• Interviews patients and patient's social support system when appropriate to identify and assess needs, evaluate resources, and work with patient, patient's support system, and the multidisciplinary team to develop a post hospital plan of care.
• Provides psychosocial assessment with the patient and develops a post acute plan of care/discharge in coordination with the Clinical Care Management team and the interdisciplinary team.
• Coordinates and facilitates post hospital planning for patients and patient's support system in conjunction with the Clinical Care Management team.
• Works collaboratively with the patients and patient's social support system to establish and implement a plan of care with multidisciplinary team that meets the patient's identified psychosocial needs.
• Serves as a resource to hospital staff and physicians regarding emotional, social, and psychosocial components of the patient's illness and its effects on their social support system. Assists and facilitates the multidisciplinary team in understanding and integrating these aspects into the plan of care.
• Intervenes in crisis situations, appropriately and effectively applying crisis intervention theory and skills
• Works with the Clinical Care Management team to assess and evaluate the patient/patient's social support system for the appropriate level of care or environment setting to meet care needs across the continuum.
• Maintains current knowledge and researches availability of community agencies and community resources for social, emotional or financial assistance.
• In collaboration with the Clinical Care Management team, provides information, education to patients and their social support on community resources and options for post hospital care appropriate to the age of the patients served. Make referrals to community agencies as needed.
• Reports suspected cases of child & adult abuse/neglect/exploitation. Serves as liaison between hospital, patients/patient's social support system and Department of Social Services during evaluation/investigation.
• Works with Clinical Care Management leadership to identify problems, recommended solutions and works toward resolution and efficient discharge planning.

Physical Requirements
Works in an office type setting, extensive walking throughout the facility. Prolonged periods of sitting reviewing medical records, documentation. Repetitive wrist motion and occasional lifting of 10-20 pounds. Requires frequent verbal and written communication in English. Intact sight and hearing with or without assistive devices is required. Must be able to handle fast-paced environment, moving independently from one location to another.

Education, Experience and Certifications

Bachelor's Degree in Social Work. North Carolina Certification preferred. At least 1 year professional experience in hospital or health related setting preferred. Experience with Word and Outlook preferred. Adherence to National Association of Social Workers Code of Ethics.