Job Title: Outpatient Social Worker

Department: Social Work

Location: St. Marys Campus (hybrid)

Hours Per Week: Per Diem (up to 28)

Schedule: Monday - Friday | Days with flexibility

SUMMARY:

As a Social Worker, you play an important and trusted role in the lives of patients and their family. You are an integral part of their care and recovery. 

RESPONSIBILITIES:

• Determine patient and family needs related to social supports, financial support or counseling, housing appropriateness, transportation and psychological supports.

• Coordinate multidisciplinary and agency case conferences; work with care managers to advocate for patient/family to obtain approval for insurance coverage; coordinate admission for all patients in need of dialysis.

• Intervene in crisis and attend to needs of patient/family related to illness, disability, deterioration of independence, etc.

• Manage referrals related to patients at risk and determine appropriate intervention strategies and document as implemented; ensure inappropriate referrals are channeled correctly and documented

• 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 

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.
 

REQUIRED QUALIFICATIONS:

• Bachelors Degree in Social Work

New Graduates:
• Official transcript from accredited school or letter emailed directly from the school’s registrar’s office confirming program completion will be accepted upon graduation.
• Primary source education verification required within 90 days of start date.

PREFERRED QUALIFICATIONS

• Masters of Social Work

• Compassionate, warm and patient focused

• Exceptional documentation and planning skills 

• Excellent communication and interpersonal skills