Position Summary:
To provide hospital patients with psychosocial and continued care planning intervention, serve as a community liaison and provide education in compliance with applicable hospital, departmental and governmental regulations and policies. High level of communication skills, excellent oral and written communication and interpersonal skills are essential.

Key Responsibilities:
• Manages referrals related to patients with psychosocial needs and determines appropriate interventions and strategies to meet those needs. Reviews track board census or documentation to identify high risk patients not referred. Determines patient needs through interdisciplinary rounds, chart review, patient/family interviews and team conferences. Documents social work intervention. Ensures that all inappropriate referrals are channeled correctly and documented.
• Assesses patient needs and determines mode of intervention. Possesses appropriate age and specific knowledge about the dynamics of group assigned and assesses patient needs accordingly as documented in Care Connect or medical record. Interviews patients and/or families and records psychosocial assessments in accordance with the social work documentation policy as documented in chart. Coordinates assessments and develops care plans in accordance with accepted social work policy as documented in chart. If indicated, evaluates patients for the appropriate level of care as documented in chart, office file, and by referrals. Coordinates multidisciplinary and agency case conferences as needed, as verified through chart notes indicating attendance, problems discussed and treatment plan.
• Implements plan of intervention preparatory to discharge or initiating continued care plan in compliance with departmental and governmental regulations.
• Works with care manager, acts as intermediary, with Health Care Insurance providers (ex. HMO’s, private insurance, Medicare), advocating for patient/family, to obtain approval for coverage as documented in the chart. Involves patient/family in the treatment planning process as demonstrated in the chart notes, and signatures on the appropriate forms.
• Executes plan of discharge/continued care which is mutually agreeable to patient/family. Notifies involved parties (ex., doctor, family, patient, facility) concerning the discharge, within 24 hours of receipt of discharge authorization as documented in chart. Requests needed paperwork from nursing/doctor other disciplines as documented in the chart.
• Arranges for transportation of patient where needed in accordance with hospital procedure, as documented in the chart.
• Acts as liaison with the community and as a referral source.
• Performs other duties as assigned.

STATUS: Full-Time, Days             

LOCATION: Unity Hospital       

DEPARTMENT: Social Work

SCHEDULE: Mon - Fri, 8am-4:30p and/or 8:30am-5p; On-Call - Rotation required a couple of times in a month       

ATTRIBUTES

• One (1) year of experience in a healthcare setting preferred
• Compassionate, warm and patient focused
• Exceptional documentation and planning skills
• Excellent communication and interpersonal skills

RESPONSIBILITIES

• Patient Care. Determine patient needs through rounds, chart review, patient/family interviews and team conferences; coordinate multidisciplinary and agency case conferences; work with care managers to advocate for patient/family to obtain approval for insurance coverage
• Referral Management. Manage referrals related to patients at risk and determine appropriate intervention strategies and document as implemented; ensure inappropriate referrals are channeled correctly and documented
• Treatment Plan Development. Coordinate assessments and develop care plan in accordance with accepted social work policy; implement plan of intervention preparatory to discharge or initiate continued care plan

EDUCATION:

LICENSES / CERTIFICATIONS: 

PHYSICAL REQUIREMENTS:

For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.

Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations.

PAY RANGE:

The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.

Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.