Case Management Social Worker - Full Time - Days

Full Time

Days 8am to 4:30pm

Lebanon, PA

Job Description:

Under the general supervision of the Supervisor-Case Management Social Work, plans, organizes and implements social work for patients and families. Works in a team type assignment or Care Continuation Team (CCT) model (Case Management Nurse and Social Worker teams are assigned to physician practices) to address patient care transition needs.

Duties and Responsibilities

1. Assesses patients/families in need of psycho-social support throughout the patient’s hospitalization and assists patients who require post acute care coordination or community resources referrals. Advocates for patient self-determination and appropriate level of care.
2. Identifies discharge plan by making arrangements for psycho-social, psychological and practical assistance across the continuum of care. Actively engages the patient and family in the assessment, problem solving and referral process including transfer and discharge plans.
3. Notifies patient/clinical team of potential referrals, documents on the medical record in a timely fashion: psycho-social assessments, identified plan, barriers, changes and progress toward plan completion. Notifies final outcome and patient satisfaction.
4. Interacts with the interdisciplinary team in the development of the discharge plan addressing the patient’s/family’s psycho-social support.
5. Coordinates family meetings. Assists patients and families in navigating the healthcare system.
6. Performs a variety of functions to address patient’s psycho-social needs with referrals for counseling, community services, protective services, and financial assistance referrals (MA application).

Qualifications

• Notes:
  • Must be degreed in social work or social welfare per PA Act 68 of 2008
  • This is a m-f, day shift, 8:00am - 4:30 pm, This is an onsite position!

• Minimum Experience:
  • 6 - 12 months

• Minimum Education:
  • Bachelor's Degree

• Required Certification:
  • BLS Certification

• Preferred Certification:
  • Social work license in PA

• Skills:
  • Excellent interpersonal/communications skills; basic computer skills
  • Able to maintain confidentiality; Able to act in a professional manner; Maintains job competency