Default Work Shift:

Day (United States of America)

Hours:

24

Salary range:

$37.19 - $56.49

Schedule:

Part Time

Shift Hours:

8 Hour employee

Department:

Ambulatory Patient Advance Access

Job Objective:

Delivers behavioral and healthcare management services to a variety of patient populations across the lifespan; coordinates the complex needs of patients and their families as well as psychosocial assessment for patients with complex psychiatric, social, medical and financial needs.

Job Description:

Education: Required: Master of Social Work (MSW) Licensure/Certification: N/A Experience: Preferred: Social work experience in healthcare setting

Reports To: Manager or Director Supervises: N/A Ages of Patients: Pediatric, Adolescent, Adult, Geriatric Blood Borne Pathogens: Minimal/No Potential

Skills, Knowledge, Abilities:

Ability to deal concretely and psychologically with a variety of crises, Ability to develop and maintain support groups for cancer patients and/or loved ones, if applicable, Ability to establish and carry out complex plans of care for key diagnoses, Ability to listen, interact and communicate with a wide variety of cultural backgrounds and socioeconomic classes, Ability to organize efforts around helping clients have a positive experience, Ability to work independently and as a team member, Critical thinking skills, Knowledge of Centers for Medicare and Medicaid Services (CMS) Health Equity Services and Social Determinants of Health (SDOH) activities, if applicable, Knowledge of regulations, standards and legislation (local, state and federal) related to the continuum of care and patient transition, Problem solving skills to identify issues and formulate effective solutions, Self-starter; driven to take action without needing prompting, Well-developed biopsychosocial assessment and intervention skills, Written and verbal communication skills

Essential Responsibilities

1. Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations. 2. Conducts comprehensive biopsychosocial assessments to understand patient’s life story, needs, goals and preferences, including understanding cultural and linguistic factors, in the areas of behavioral health, substance use, abuse/neglect, financial, medical and other needs. 3. Facilitates behavioral change necessary for meeting diagnosis and treatment goals, including promoting patient motivation to participate in care and reach treatment goals. 4. Facilitates and provides tailored social and emotional support for the patient related to coping with problem(s) being addressed; may be required to counsel with patients/loved ones regarding end-of-life issues. 5. Helps the patient contextualize health education provided by the patient’s treatment team and educates the patient and/or caregiver on how to best participate in medical decision-making. 6. Performs periodic administration of SDOH survey tools and monitoring of related SDOH, if applicable. 7. Conducts screenings to evaluate the needs of patients for behavioral health and support services. 8. Provides SDOH management services for behavioral health conditions, including psychoeducational counseling and crisis intervention as necessary. 9. Sets personalized goals and creates action plans and conducts follow-up/on-going interventions as appropriate. 10. Builds patient self-advocacy skills in ways that are more likely to promote personalized and effective treatment of their problem(s) identified. 11. Coordinates with clinical, health education, community health and other team members in the provision of services to patients and care transitions. 12. Helps the patient arrange access to medical care, including securing medical or community-based appointments, identifying appropriate providers for care needs, identifying appropriate community-based resources for SDOH related to problem(s) identified during the initiating visit, and for accessing all clinical care services necessary. 13. Performs coordination of receipt of needed services from practitioners, providers and facilities, home and community based services, and caregiver if applicable. 14. Conducts coordination of care transitions between and among health care practitioners and settings, including referrals to other clinicians. 15. Conducts communication to and from practitioners, home and community-based services regarding the patient’s psychosocial needs, functional deficits, goals, and preferences. 16. Serves as a resource to interdisciplinary team concerning social issues. 17. Serves as a field instructor for social work students as well as a mentor to social work team, if applicable. 18. Collaborates with interdisciplinary team to promote continuous process improvement, which results in efficiency, cost effectiveness, and the highest level of clinical excellence. 19. Calls in and writes APS, CPS and suspicious injury reports in collaboration with the interdisciplinary team when warranted. 20. Documentation will follow documentation standards and will demonstrate intervention that supports services provided; documents using facts only without attitude, judgment or opinions; includes all telephone calls made with person’s name and phone number. 21. Assists in program development and implementation for support services programs (cancer lecture series, teleconferences, support groups, etc.); leads or co-facilitates a support/educational group as needed, if applicable. 22. Performs other duties as assigned.