Integrated Behavioral Health Medical Social Worker

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Integrated Behavioral Health Medical Social Worker
- Baystate Medical Center

Department:
Social Work

Location:

Baystate Medical Center

Make an Impact with Baystate Health

• Job Type: Full time
• Hours: Monday – Friday 8-4:30 or 8:30-5
• Schedule: Days

The Social Worker I – Ambulatory (“SW-I”) As an integral member of the multidisciplinary care team that provides services based on the unique needs of each patient, the SW-I is responsible for addressing the psychosocial and behavioral health issues that arise in the ambulatory practice setting. Through a range of focused social work interventions and practices, the role is designed to guide and assist patients, families, physicians, nurses and other members of the health care team to work through an identified problem, to positively affect the patient's continuity of care, and to reach optimal outcomes.

1) Provides Social Work assessment and counseling skills and refers patients to resources such as home-based services, educational support, housing, advocacy, welfare assistance, and other services. Demonstrates skilled assessment and knowledge about human behavior and theory including the psychosocial adjustment to illness and treatment impacting a patient as it relates to age‑specific needs, stages of growth and development and coping with illness and other life stressors.

2) As part of the assessment, evaluates the patient and family's support system, economic status, and any immediate needs in order to help patients and families access community resources for mental health, financial (entitlement programs), housing, insurance, and transportation services. Assesses the risk of abuse/neglect for children, disabled adults and/or elders as appropriate. File reports with appropriate agencies as needed Works as a responsible advocate for the patient's and family's concrete needs and services.

Serves as a liaison with community resources on behalf of the patient.

3) Conducts interviews with patients and their families/support persons to assess and identify issues and help patients and families adjust to their situations through a range of focused social work interventions.

4) Coordinates input from all health care professionals, patient and family members to formulate a documented plan of care assuring continuity of care on a daily basis.

5) Provides clinical consultation as an active member of the interdisciplinary care team regarding psychosocial issues, bio-ethical issues, barriers to care and other issues affecting patients and their families.

6) Supports the mission and philosophy of the department as well as the Operating and Service Standards of Baystate Health.

7) Utilizes the dynamics of the health care delivery network to foster the best use of resources, effective service delivery, and patient and family satisfaction. Coordinates with inpatient social workers as needed

8) Plans and coordinates patient care conferences including follow-up interventions between the medical team and family as needed.

9) Enters data and information into the electronic medical record and other electronic systems in order to maintain accurate clinical records for patients and ensure an integrated approach to care. Prepares reports timely, maintains accurate records for legal action. Refers patients to appropriate community resources including domestic violence referrals. Works in partnership with the care team coordinating referrals and follows-up on care coordination…