Social Worker II-MSW - Main Campus - Part Time

Social Worker II-MSW
- Main Campus
- Part Time
- Days

Apply for the Social Worker II-MSW
- Main Campus
- Part Time
- Days role at The Christ Hospital Health Network
.

Primary

Purpose:

Provide comprehensive psychosocial services to patients and families by assessing needs and developing individualized discharge plans to ensure continuity of care. This part‑time position (.5 FTE; 40 hours per pay period) follows a rotating schedule—three days one week and two days the next—and will primarily support OB/NICU patients while serving as a Med/Surg float.

Primary

Purpose:

Provide comprehensive psychosocial services to patients and families by assessing needs and developing individualized discharge plans to ensure continuity of care. This part‑time position (.5 FTE; 40 hours per pay period) follows a rotating schedule—three days one week and two days the next—and will primarily support OB/NICU patients while serving as a Med/Surg float.

• Assess patients’ evolving medical situation from a psychosocial framework, including functional status, goals of care, and community support needs as it relates to discharge planning
• Assess family structure, dynamics, and decision‑making preferences, including identification of a surrogate decision maker if needed
• Assess patient/family environmental risk factors, patient/family/community support systems, age‑related/developmental issues, financial barriers, health literacy, chemical dependency/mental health, Social Determinants of Health needs, and any risk of abuse/neglect/financial exploitation/intimate partner violence
• Assess for risk of readmission, putting into place a coordinated plan for outpatient follow up

• Documents in discharge planning progress notes a clear, concise, objective psychosocial assessment, treatment plan, and progress of social work intervention and outcomes in compliance with regulatory standards and departmental standards for timeliness.
• Documents appropriately in the Social Work module for data tracking purposes.

• Develop a plan of intervention, integrated with the interdisciplinary treatment team to establish continuum of care in congruence with ethical and legal considerations.
• Provide psychosocial counseling and other therapeutic interventions for patient/family.
• Provide crisis management for patient/family.
• Facilitate healthcare decision making and resolution of discharge planning issues.
• Provide psychosocial intervention for: neglect/abuse/intimate partner violence/human trafficking; adjustment to illness; bereavement and mental health; substance abuse; non‑compliance, and other psychosocial barriers to diagnosis and treatment.
• Mandated reporting to local/state agencies as required by law – Adult Protective/Child Protective Services, law enforcement.
• Maximize health status and minimize length of stay and appropriate utilization of hospital resources.
• Provide referral and linkage to health care and community resources based upon Social Determinants of Health screening needs.
• Facilitate extended care facility placement and hospital to hospital transfer.
• Facilitate home care, hospice care, and durable medical equipment arrangements.
• Advocate, mediate and negotiate a cohesive plan for maintaining or improving social supports and patient safety.
• Coordinate patient’s discharge plan with outpatient counterparts – TCHMA SW, insurance case managers, community mental health/substance abuse case managers – to aid in readmission prevention.

• Attend unit specific interdisciplinary rounds daily.
• Collaborate with interdisciplinary team to enhance quality of care and efficiency.
• Maintain a positive working relationship with healthcare team and community agencies and services.
• Provide extensive education to patient/family in areas of insurance benefits, and capacity of community resources to meet patient needs.
• Participate in interdisciplinary patient care rounds, case conferences and family conferences for purpose of appropriate length of stay discharge planning.
• Assist interdisciplinary team in understanding significant social and…