Social Services Director - Avamere Rehab of Hillsboro

Social Services Director

Status:
Full-Time

Location:

Avamere Rehab of Hillsboro - 650 Oak Street, Hillsboro, OR 97123

Job Summary

The Social Services Director oversees the operation of the facility's Social Services Department in accordance with current federal, state, and local standards, guidelines, and regulations, as well as Avamere's established policies and procedures, to ensure that the medically related emotional, mental, and psychosocial needs of the residents are met. Additionally, the Social Services Director acts as a liaison between the resident/family and community partners, providers, and payors to ensure safe discharge planning and continuation of care.

Essential Duties and Job Responsibilities

• Identifies residents' emotional, mental, and psychosocial needs and ensures that comprehensive care plans are in place and up to date
• Works with the interdisciplinary team to identify discharge plans, barriers, and needs in order to effectively coordinate a safe discharge from the facility
• Communicates with residents, families, community providers and programs, and any other parties, on a consistent and timely basis
• Acts as the resident advocate by ensuring that their resident rights are upheld and that all parties are acting in the best interest of the resident
• Coordinates with community support services such as home health, hospice, and durable medical services to ensure that residents have the supports and services they need post-discharge
• Arranges for provision of ancillary services for residents while they are in the facility
• Coordinates and conducts regular care conferences with residents and families as well as other meetings as needed
• Monitors residents' mood and behaviors, creates behavioral support plans as appropriate, and assists residents in seeking mental health supports and services if needed
• Works with insurance companies and other payors to ensure payment for skilled nursing and/or long-term care services and issues non-coverage notices on behalf of Medicare and insurance companies
• Assists patients and families in applying for Medicaid services, including spend downs
• Assists patients and families in finding appropriate placement in outside facilities following discharge from Avamere facilities
• Acts as the point person and record keeper for grievance and lost items
• Assists patients in obtaining clothing and other personal items as needed
• Participates in facility quality assurance program and other meetings as required
• Performs other duties as assigned