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SalaryJOB SUMMARY:
A Medical Social Worker at Complete Health will assist patients in navigating support services and med-legal processes that are associated with obtaining optimal health. The incumbent will assist the integrated care team, including care coordination with the execution of community resource referrals, application assistance, and biopsychosocial assessments. With the assistance of the RN Case Manager, he/she will attend home visits or initial intake to review the patients' capacity to function independently and identify any barriers that may impede on their health and well-being. Basic med-legal processes will need to be initiated by the Medical Social Worker, including power of attorney, mandated reporting, and end-of-life planning. Other duties may be assigned to suit the demands of patients; according to the respective location of the clinical site.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Conduct biopsychosocial assessments and screenings on high-risk or non-compliant patients
- Promote and refer appropriate patients to behavior health providers or related services
- Conduct referrals to community-based resources such as transportation services and local food banks
- Serve as an advocate for patients and their patients in challenging situations; including hospice treatment
- Assist patients' and their families with applications such as VA benefits, Social Security, and disability
- Investigate homes and patient social dynamics for evidence of abuse or neglect
- Initiate med-legal proceeding for processes such as power of attorney and end-of-life planning
- Identify, establish, or reinforce care plans for designated social support for patients
- Participate in quality improvement activities by initiating or contributing to monitoring, measuring, analyzing, improving and/or controlling program goals, objectives and/or services.
- Support current incentive, regulatory, and certification requirements (through documentation, participation in initiatives, and other activities as directed.
KNOWLEDGE/SKILLS/ABILITIES:
Knowledgeable of basic functions of care coordination, discharge planning, or case management. A basic understanding of major community-based resources; including housing, transportation, and food pantries. Experience in collaborating with primary care, specialists, hospitals, home health, and other essential health agencies. Strong skills in biopsychosocial assessments, elder and family affairs, and med-legal processes. An understanding of cultural competency, health literacy, and social determinants of health as it relates to promoting positive health outcomes. Interacts with respect and in a professional manner with patients, staff and external customers.
A general knowledge of primary care practice and/or community health. Must have previous experience with working with underserved populations (such as the homeless and/or ethnic minorities). A working knowledge or relationships with local community resources. Must have personal effectiveness and credibility, leadership and collaborative skills, communication proficiency and flexibility. Must be able to work independently and as a Team Player. Excellent verbal and written communication skills. Able to work independently and in a multidisciplinary team.
EDUCATION AND EXPERIENCE REQUIREMENTS
. Experience: 1 to 3 years professional experience providing traditional social work services in a clinical setting OR at least 1 year of experience in case management, care coordination, or discharge planning OR at least 1 year of employment with Department of Human Services, Elder Affairs, or any patient advocacy organization
. Additional skills required: Knowledge of community resources; including social services, medical specialists, and other treatment programs. Excellent leadership and coaching skills. Strong computer skills with knowledge of Microsoft Office products. Excellent verbal and written communication skills. Able to work independently and in a multidisciplinary team. Able to effectively utilize an electronic health record to document all patient encounters.
. Additional skills preferred: Knowledge of behavioral health or substance abuse treatment.
Education: Bachelor's Degree in Sociology, Social Work, or related field.
Licensed Clinical Social Worker (LCSW) certification is preferred.
Strong computer skills and proficiency in internet software and knowledge of Microsoft Office products is required. Able to effectively utilize an electronic health record. Athena EHR experience preferred.
