Relocation Assistance Available!! FacilityHighsmith Rainey Specialty HospitalLocationFayetteville, North CarolinaDepartmentCoordination of CareJob FamilyProfessionalWork ShiftDaysSummaryComprehensively plans for services for a targeted population. Responsible for psychosocial assessments, crisis intervention, discharge planning, and coordination of referrals and resource information to patients and families in need of assistance.
Independently identifies complex patients as well as receives referrals from nursing and other ancillary staff. Provides an array of social work services to patients and families to promote understanding and resolution of problems related to environmental stress, physical illness, interpersonal conflicts, and other psychosocial issues. Adheres to the patient experience initiatives and champions customer service.
Works collaboratively to ensure patient needs are met and care delivery is coordinated across the continuum at the appropriate level of care. Major Job FunctionsThe following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below.
In addition, specific functions may change from time to time:Conducts face-to-face interviews with patients and family members to develop therapeutic relationships and obtain psychosocial and financial information necessary for the facilitation of appropriate discharge planningPerforms proactive screenings and assessments for patients’ clinical, psychosocial, and discharge planning needsDocuments assessment, the on-going plan, case progress, intervention(s), and reassesses patients as neededInitiates referrals and recommends consults to enable patient to be prepared for safe and timely discharge or transferAssists patient/family in coping with hospitalization, disability, and chronic/terminal illnessUtilizes communication, negotiation, and advocacy skills with patient, family, healthcare team and communityProvides information, education to patient/family on community resources and options for post-acute care appropriate to the age of the patient servedCarries out discharge planning activities to include providing arrangements for Home Health, Hospice, Home Infusion, DME, Outpatient Hemodialysis, Rehab, LTAC, Assisted Living, Rest Home and Skilled Nursing Facility placementsProvides alternate plan of care options at the appropriate level of care based on patient/family needs and in collaboration with physician and/or designated team membersServes as a resource for processing issues such as guardianship, abuse, neglect, power of attorney, healthcare surrogate, advance directives or psychiatric involuntary commitment.
Initiates/completes forms required for post-acute placement. Serves as a reliable resource for the Acute Care Nurse Navigator for difficult placements, information on Medicaid and disability, and Department of Social Service ReferralsConsults with the Acute Care Nurse Navigator when clinical explanation of disease processes, clarification of physicians’ orders, and other pertinent information is needed to determine, safe appropriate discharge planOther duties as assignedMinimum QualificationsThe following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:Education and Formal Training: Bachelor’s degree in Social Work requiredMaster’s degree in Social Work (MSW) preferredProfessional Certification in Case Management or Social Work (CSW, CCM, or ACM) preferredWork
3 years’ experience in Social Services, Home Health, Hospice, Skilled Nursing facility, or Acute Care setting required. Acute Care Case Management experience preferredHospital experience as a social worker required. Knowledge, Skills, and Abilities Required: Proficiency in reading, writing, and speaking the English languageFlexible with scheduled hours to meet the needs of the department, unit, patient and familyWork is not standardized and requires a high degree of prioritization skillsExcellent interpersonal communication and negotiation skillsAbility to communicate effectively and work with people of all social, economic and cultural backgroundProven written, telephonic and electronic communication skillsAssertive and persuasive in interactions with customers, peers, management and core staff servedStrong organizational and time management skillsProficiency with various computer programs including Microsoft Office, Midas, ProviderLink, ValleyLink, eHIM, and SMSAbility to demonstrate respect and team buildingFlexible, open-minded and adaptable to changeAbility to work collaboratively with department staff, physicians and healthcare professionals at all levels to achieve established goals, improve quality of outcomes, maintain or exceed Joint Commission standards and State mandates as they apply to the department operationsPhysical
Light carrying and lifting may be requiredWalking may be required to access all areas of the Medical CenterAbility to effectively communicate orally to patients, family members, personnel and physiciansVisual acuity to proofread hand or typewritten materialsManual ability to use telephones and computer keyboardRequired Licenses and CertificationsCSW - NC Social Work Certification And Licensure BoardCape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity