Social Worker (MSW) interviews clients and their families and coordinates and plans programs and activities to meet their social and emotional needs. Provides crisis intervention and assists families in understanding the implications and complexities of the life situation and its impact on lifestyle. Being a Social Worker (MSW) provides professional social work assistance to clients and families as related to illness, disease, hospitalization, financial and educational needs by utilizing a variety of modalities in all areas of service. Responsibilities also include involvement in the discharge planning process. Additionally, Social Worker (MSW) requires a master's degree. Typically reports to a manager. Social Worker (MSW)'s years of experience requirement may be unspecified. Certification and/or licensing in the position's specialty is the main requirement. (Copyright 2024 Salary.com)
US:NV:Carson City Integrated Care Management
Part Time Day Shift
About Carson Tahoe Health
CTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by the Center for Improvement in Healthcare Quality (CIHQ). CTH was voted 5th most beautiful hospital in the nation nestled among the foothills of the Sierra Nevada in North Carson City and only a short drive away from world-famous Lake Tahoe & Reno. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.
Summary
• This individual is responsible to facilitate care through the continuum utilizing effective resource coordination to promote optimal access to care balancing the patients’ resources and right to self-determination • The overall responsibility to assess the patient for transition of care needs and risk for readmission • This individual will be able to conduct complex psycho-social assessments and provide interventions to assist with throughput, safe discharges and avoid readmissions • Has focus on complex social and post-acute care services
Responsibilities
Transition Management
• Completes initial /comprehensive assessment within 24 hours of admission, including anticipated transition (discharge) plan
• Provides psycho-social assessment and intervention for patients identified with behavioral health issues, lack of social support systems, financial barriers, end of life and plan of care adherence
• Ensures plan of care and interventions are implemented and communicated to health care team, patient/family and post-acute care providers
• Complete timely, accurate and concise documentation in the Electronic Medical Record
Care Coordination
• Screens high risk and referred patients for psycho-social issues/barriers, that may impact the transition plan and intervenes as appropriate
• Assists with adoption/abuse/neglect cases and reports to appropriate external agencies as required
• Collaborates with patient/family/health care team to ensure patient preferences and choices are taken into consideration within the limitations of available resources
Education
• Ensure patient/ family receive education appropriate to their specific discharge plan
• Provides education to medical and nursing staff regarding relevant issues related to transition plan
• Precepts new staff members and acts as resource to all staff
Compliance
• Ensures compliance with local, state and federal regulations and accreditation requirements
• Operates within social work scope of practice as defined by the state licensing board
• Participates in department Quality improvement initiatives
Complex Case Management
• Completes clear, concise and accurate initial/discharge planning/complex psycho-social assessments and reassessments per departmental guidelines (assessments within 24 hours of admission, reassessments every 3 days or as needed for change)
• Escalates barriers to transition planning per departmental escalation plan
• Completes post-acute referrals within 3 days of admission
• Schedules and facilitates complex case patient/family conferences as needed (at a minimum of weekly)
Qualifications
Required: o Master in Social Work from accredited school of Social Work o Excellent interpersonal, written and verbal communication skills o Demonstrated organizational skills, critical thinking and problem solving skills and computer literacy o Unrestricted Social Worker license (LSW) in the State of Nevada Preferred: o Two (2) years of acute care coordination experience o Ability to obtain Accredited Case Manager (ACM) certification
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