Social Work Coordinator - Bridge Clinic

Hours: 40 hours weekly. Monday-Friday 830am-5pm

Job Profile Summary

This role focuses on safeguarding and promoting the welfare of patients and can provide services if necessary. In addition, this role focuses on performing the following Social Work duties: Provides social work assistance to patients and families relating to illness, disease, hospitalization and life events in all areas of service as a member of multi-disciplinary team and in liaison with community resources. Responsibilities also include identification, assessment, and coordination of cases and anticipation of needs related to illness, hospitalization, finances, education, and home/community service. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or deviation from standard procedures, and communicates information that requires some explanation or interpretation.

Job Overview

Under the orders of a physician, and the supervision of the Clinical Manager and Medical Social Worker, the position provides care to patients in need of supportive or therapeutic counseling and/or patients in crisis due to medical, socio-economic or family issues. Provide social work services and treatments according to the patient's plan of care, patient assessments under the guidance of the Medical Social Worker, and accepted standards of practice.

Job Description

Minimum Qualifications:

1. Bachelor's degree in Social Work

2. Social Work License (LSW)

3. One (1) year of social work experience in a health setting.

Duties and Responsibilities: The duties and responsibilities listed below are intended to describe the general nature of work and are not intended to be an all-inclusive list. Other duties and responsibilities may be assigned.

1. Develops a care plan and coordinate this plan under the supervision of the Medical Social Worker.

2. Provides counseling services to patients to assist the patient to cope with his/her medical condition and to respond to treatment.

3. Provides short-term therapy with goal-oriented interventions directed toward management of terminal illness, reaction and adjustments to an illness, and resolving conflicts related to the chronicity of an illness.

4. Provides community resource planning by establishing the need for and making referrals to community resources such as supplemental health care, meals on wheels, food stamps, advocacy and linkages.

5. Demonstrates sound clinical judgment in assessing the patient's needs for long-term care, including evaluating the home and family situation, helping the patient and family to develop an in-home care plan, exploring alternatives to in-home care and arranging for placement if necessary.

6. Provides medical social services to the patient's family member or caregiver on a short-term basis when necessary to remove a clear and direct impediment to the effective treatment of the patient's medical condition or rate of recovery.

7. Provides all services under the supervision of the Medical Social Worker.

8. Participates in inservice programs, case conferences and discharge planning.

9.Acts as consultant to other agency personnel.

10. Assures clinical record documentation and EMR accurately reflect all clinician and support activities.

11. Submits documentation in a timely fashion: admissions within 24 hours; submits clinical notes, documents and EMR within 24 hours; updates clinical record and schedule with changes immediately; and completes discharges within 48 hours.

12. Provides for the safety and confidentiality of the medical record.

13. Complies with documentation regulations (Medicare, Medicaid, DPH, OSHA, JCAHO, State and Federal regulations) and agency policies and procedures.

14. Creates documentation demonstrates evidence of interdisciplinary case coordination and case management per agency standards.

15. Obtains and documents all physician's orders for care.

16. Prepares clinical and progress notes and completes documentation on services to patients immediately following each visit.

17. Communicates with Medical Social Worker and Clinical Manager regarding caseload size.

18. Provides continuity of care for patients on caseload.

19. Maintains an accurate visit schedule and ensures patients are scheduled for visits according to clinical need/acuity.

20. Works with Clinical Manager to arrange coverage for patients when not scheduled to work.

21. Exhibits flexibility in patient scheduling.

22. Meets agency productivity standards.

23. Ensures visit schedule is organized to meet productivity guidelines established by agency.

24. Works collaboratively and effectively with coworkers, supervisors, team members and outside contacts to plan, deliver and evaluate patient care and related work.

25. Uses available resources (e.g. Language Line and written materials) to assure culturally competent or culturally sensitive care and communication is provided to patients and families.

26. Consults with the physician and other team members to assist them in understanding significant social and emotional factors related to the patient's health problems.

27. Demonstrates a knowledge and understanding of what to report to the CEO or Chief Compliance Officer when concerns of corporate compliance arise.

28. Ensures compliance within guidelines set forth by regulatory agencies (DPH, ERISA etc.) and demonstrates compliance with Home Health Foundation policies and procedures.

Physical Requirements:

1. Prolonged, extensive, or considerable standing/walking.

2. Lifts, positions, pushes and/or transfer patients and equipment.

3. Considerable reaching, stooping, bending, kneeling, crouching.

4. Frequent exposure to hazardous chemicals, sick patients, bodily substances, noise and possible exposure to radiation, lasers, electric shock, etc.

5. Regularly exposed to the risk of blood borne diseases and other transmissible infections.

6. Contact with patients under wide variety of circumstances.

7. Subject to varying and unpredictable situations.

8. Handle emergency and crisis situations.

9. Subjected to irregular hours.

10. May have contact with hazardous materials.

Skills & Abilities:

1. Excellent interpersonal and organizational skills.

2. Able to work with detailed, confidential material.

3. Computer experience.

4. Familiarity with a hospital setting.

5. Ability to read/write and communicate in English.

6. Ability to function well in very busy situations.

7. Responsible and reliable.