Social Worker; BSW- Indiana Locations

Regular

40

Reports to Care Management Social Services Program Manager, the Licensed Social Worker (LSW) is a member of the Care Management – Integrative Care Team. This role helps in population health by accessing community resources and navigating the patient through various systems that are cumbersome and difficult to navigate as a layperson The LSW will also be responsible for face-to-face encounters with patients when necessary in various locations within their region such as in the primary care office, Medicaid office, Library and patient’s home.

The LCW helps with DME, medication assistance programs, food/housing/transportation/WIC/SSI/SSDI/Medicaid application, food stamps, Medicare, Long-term housing, safety needs, etc. This role provides direct communication with physicians, integrative care specialists, nurses, health-care advocates, care coordinators; DME companies; community partners and agencies; lawyers; housing entities; etc. The LSW works closely with the entire integrative care team and primary provider to provide optimal services to the patient.

The LSW demonstrates respect, dignity, kindness and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background. The LSW is responsible for creating a positive impression with patients, physicians and other visitors he/she encounters, both in person and on the phone.

_ Required Stevens Amendment Disclosure: _ This Rural Health Transformation Program is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $.80 with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government

• No on call
• No Nights, Holidays, or Weekends
• Paid Time Off
• Medical, Dental, and Vision
• 403b with Match
• Opportunity for Career Growth

Licensed Social Worker (LSW) - Kentucky Board of Social Work (KYSW)
Licensed Social Worker (SW) - Indiana Social Worker (INSW)

BSW degree accredited program.

0-3 years.

1. Comply with all applicable laws and regulations.
2. Provides patient centered evaluation and care planning, resource coordination, and health and safety education during community paramedicine home visits.

1. Manage a caseload of patients that have been assessed as high risk and patients with high utilization of the health care system. Gather all relevant data, objectively evaluate data, and obtain information by communicating with the patient/patient’s family, the Primary Care Physician, other members of the healthcare team, and patient’s community support network.
2. Initiate contact with patient/family via phone within 1 business day from referral date.
3. Complete social determinate needs assessment that holistically assess the patient.
4. Identifies barriers and works with patient/family to resolve them.
5. Complete face to face visits with patients as necessary. Face to face visits can be held in the PCP office, community setting or home environment.
6. Assist with patient’s requests in a timely manner.
7. Communicates appropriate and applicable information on chart in accordance with HIPPA guidelines.

1. Completes thorough chart review upon receiving a social work referral
2. Shares information with Integrative Care Specialists, Care Coordination Staff (HCA’s, CTT), Practice Physicians or APRN/PA and office staff…