Senior Social Worker
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Wilmington, DE 19808
Christiana Care Carelink CareNow, a robust information technology enabled network of care coordination support services, is searching for a Senior Social Worker I to assist patients and families identify social, emotional, and environmental needs, and to connect them with available resources/ services through the provision of a full spectrum of discharge planning and social work services.
PRINCIPAL DUTIES AND RESPONSIBILITIES
- Collaborates with the patient/family, physicians, staff, and other health care professionals across the continuum to provide care coordination.
- Works with the patient, family, and other members of the health care team to formulate a transition plan that provides the patient services in the appropriate post-acute care setting.
- Performs risk, psychosocial and transitions assessments as indicated, collaborating with interdisciplinary team according to craft treatment plans consistent with evidence-based care guidelines
- Identifies problems or gaps in community resources that impact outcomes and takes leadership in efforts to effect changes. Coaches patients on red flags, triggers, medication management, and follow-up appointments.
- Gathers and assesses information regarding the patient’s physical needs, mental status, family support system, financial resources, and available community and governmental resources.
- Provides psychosocial support through individual, group, or family counseling, as needs dictate. Continuously reviews service area for group support needs and opportunities.
- Reports information generated from available sources to support operational, clinical, financial and outcome goals.
- Educates the community and the general public regarding various symptoms and consequences related to specific diseases, conditions and hospitalization. This information will also include specifics regarding methods of professional intervention and description of the process of social work intervention in a medical setting.
- Measures effectiveness of social work interventions through direct communication with patients and caregivers and data collection of defined indicators (e.g. overall length of stay, readmission rates, feedback from referral sources, etc.)
- Collaborates with other members of the care management team to achieve case management, clinical, operation and financial outcomes.
- Serves as a resource to nursing and ancillary staff, providing education on care management as needed.
- Trends potential barriers to patient advancement through the system, intervenes assertively and appropriately when necessary.
- Demonstrates skills and knowledge necessary to provide care appropriate to adult and geriatric patients, including knowledge of growth and development, the ability to obtain and interpret information to identify patient needs, and to provide the care needed.
- Identifies need for patient evaluation by other members of the health care team or specialists and in conjunction with physician advisor, takes appropriate action to facilitate evaluation.
- Represents Christiana Care, when requested, through participation on community/state boards, committees, panels, court hearings, etc.
- Performs assigned work safely, adhering to established departmental safety rules and practices. Reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, patients and visitors.
- Performs other related duties as required.
EDUCATION AND EXPERIENCE REQUIREMENTS:
- Master’s Degree in Social Work is required.
- Licensed Clinical Social Worker (LCSW) in the state of DE is required. Will need to obtain LCSW within States of NJ, PA, and MD within 90 days of hire.
- Minimum of 2 years’ experience related work experience in hospital discharge planning, health plans and or home care preferred.
Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.