Position Summary
General Summary/Responsibilities:
The Social Workerwill be an integral member of the AIM multidisciplinary team. Together with nurses and community health coaches, the Social Workerwill assist in care plan implementation, provide short-term counseling to patients, help develop care management strategy for enrolled patients and help create linkages for the various health and social needs of patients. The team works in the field in a variety of settings, including patient homes, medical centers, and the ED/inpatient floors of each Premier Health hospital.
DIMENSIONS:
Interventions per program and physician's plan of care.
Scope/Span of Control: N/A
Supervisory Responsibilities (if applicable)
Supervises FTEs: No
Number of FTEs Supervised: 0
Exercises full management authority including performance reviews, discipline, termination and personnel hiring No
Fiscal Responsibilities (if applicable)
Annual Revenue in Dollars: N/A
Annual Expense in Dollars: N/A
Financial Accountability: N/A
Population Served
Age of Population Served - Choose all that apply
Infant (birth - less than 1 year)
Pediatric/Adolescent (1 - less than 18 years)
Adult (18 - 64 years)
Geriatric (65 years & older)
All Age Groups (Birth & Above)
Not Applicable
Organizational Standards
Work in conjunction with nurse navigator on intake assessment including social needs/barrier identification of patients referred and enrolled in the program; determine plan for care with nurse navigator; responsible for management and completion of social/behavioral tasks for each individual patient
o Tasks may include, but are not limited to:
Education geared toward self-reliance and independence
Interventions aimed at reducing barriers to medical care
Coordinate behavioral health services
Assist pt in making appointments as necessary and accompany patients to appointments as needed
Referrals to community resource services
Engage patients across care settings such as the transition from hospital to home
Assist patients and their families with personal and environmental difficulties which predispose them toward illness or interfere with achieving maximum level of functioning and self-sufficiency
Act as a liaison between hospitals, primary care providers, specialists, community resources and managed care/insurance plans on behalf of enrolled patients to ensure patient-centered coordination of care
Serves as a patient advocate and assists in the identification and improvement of service delivery.
Provide crisis intervention as needed
Provide direct supervision to the community health coach
Develop and maintain partnerships with local service organizations and community resources to broaden support services for patients
Provide Notary Public services to patient/family members in order to complete Advance Directives.
Enter and maintain electronic records, compile reports and complete other program documentation in a timely manner , other administrative responsibilities as needed
Participate in interdisciplinary case conferences, staff meetings and team meetings
Play a consistent and active role in program development and growth
Meet on a regular basis with clinical supervisor to review case workload.
Essential Duties & Functions
Essential Duties & Functions:
Must have available phone to communicate and transportation, with appropriate licensure and insurance, to visit homes and other sites. Interacts with physicians, nurses, Social Workers and other disciplines, administrative personnel, and community resources.
Other Duties & Functions:
As assigned
Education
Minimum Level of Education Required: Master's degree
Additional requirements:
Type of degree: Master's degree is preferred
Area of study or major: MSW
Preferred educational qualifications: N/A
Position specific testing requirement: N/A
Licensure/Certification/Registration
Current Licensure (LSW, LISW preferred) in the State of Ohio
Experience
Minimum Level of Experience Required: 3 - 5 years of job related experience
Prior job title or occupational experience: 3-5 years of experience providing clinical services; experience in home care or community/outpatient setting preferred.
Prior specific functional responsibilities: N/A
Preferred experience: N/A
Other experience requirements: N/A
Knowledge/Skills
Ability to effectively provide clinical care to socially and medically complex patients in a variety of non-traditional settings
Ability to work collaboratively in a team and manage multiple priorities, utilize effective time management skills, and exercise sound administrative and clinical judgment
Demonstrated ability to work well with people of various ages, backgrounds, ethnicities, and life experiences
Exceptional organizational and interpersonal skills, with attention to detail required; strong oral/written communication skills is a must
Computer skills necessary
Must be capable of standing, stooping, bending and lifting up to 50 lbs.
Other duties and responsibilities as directed.
Physical Requirements & Working Conditions
Physical Requirements:
Pulling
2 - Occasionally (11% - 40%)
Standing
3 - Frequently (41% - 75%)
Other sounds
3 - Frequently (41% - 75%)
Twisting
2 - Occasionally (11% - 40%)
Reaching
2 - Occasionally (11% - 40%)
Visual Acuity Near
3 - Frequently (41% - 75%)
Walking
3 - Frequently (41% - 75%)
Manual Dexterity
2 - Occasionally (11% - 40%)
Visual Acuity Far
3 - Frequently (41% - 75%)
Sitting
2 - Occasionally (11% - 40%)
Use both hands
3 - Frequently (41% - 75%)
Vision Color
2 - Occasionally (11% - 40%)
Pushing
2 - Occasionally (11% - 40%)
Talking
3 - Frequently (41% - 75%)
Concentrating
3 - Frequently (41% - 75%)
Climbing
1 - Rarely (0% - 10%)
Lifting <10 pounds
3 - Frequently (41% - 75%)
Interpersonal Skills
4 - Consistently (76% - 100%)
Stooping
2 - Occasionally (11% - 40%)
Lifting >10 pounds
2 - Occasionally (11% - 40%)
Reading
4 - Consistently (76% - 100%)
Kneeling
1 - Rarely (0% - 10%)
Normal hearing both ears
3 - Frequently (41% - 75%)
Thinking
4 - Consistently (76% - 100%)
Working Conditions:
1. General office environment.
2. Climate controlled environment.
3. May work some evenings and weekend hours to complete projects or meet the needs of the department.
4. May be required to work overtime as defined by the needs of the department.