34033 Wilkes Medical Center - Nursing: Care Coordination

Full time

Yes

40

First Shift

Pay Range:

$28.55 - $42.85

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. applicable state 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.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.