Social Worker; Sumter

Overview

The Social Worker plays a vital role as part of the care team within our organization. This role serves as a patient advocate, empowering patients to actively participate in their healthcare decisions and treatment plans by fostering self-awareness, self-advocacy, and coping skills to effectively manage their health conditions and navigate the healthcare system.

• Assessment and Screening:
  Conduct advance care planning and cognitive assessments to identify patients  needs, strengths, and challenges. This may include screening for mental health conditions, substance abuse issues, domestic violence, and other social determinants of health.
• Crisis Intervention:
  Offer immediate support and intervention for patients experiencing acute mental health crises, including suicidal ideation, self-harm, or emotional distress.
• Coordination with Care Team:
  Collaborate closely with care team members to coordinate comprehensive care plans that address both medical and psychosocial needs.
• Resource Referral:
  Facilitate connections between patients and community resources, such as support groups, mental health services, financial assistance programs, transportation services, and home health care agencies.
• Advocacy:
  Serve as an advocate for patients to ensure their needs are addressed within the healthcare system and community settings, including access to social services, disability benefits, housing assistance, or legal support.
• Family Support:
  Provide guidance, education, and counseling to patients  families and caregivers to help them navigate challenges of caring for a loved one with complex medical and psychosocial needs.
• Documentation:
  Maintain accurate and confidential documentation of assessments, treatment plans, progress notes, and communication with patients and other healthcare professionals in accordance with legal and ethical standards.
• Cultural Competence:
  Recognize and respect the cultural, ethnic, and socioeconomic diversity of patients and tailor interventions to meet their needs and preferences.
• Chronic Care Management:
  Provide continued education and strive to enroll eligible patients into the CCM program. Accurately document and log CCM activities and collaborate with the care team to keep CCM care plans up to date.
• Communication with Care Team:
  Facilitate communication among the patient s care team to ensure a comprehensive and integrated approach to health care delivery. Communicate with providers and staff via phone, email, Teams, Athena, or in-person.
• Patient Communication:
  Interact with patients via email, patient portal, telephone, text, in-person, etc. to gather information, schedule and confirm appointments, provide pre-appointment instructions, respond to inquiries, resolve scheduling conflicts, and assist in rescheduling when necessary.
• Staff Communication:
  Foster effective communication between the care team to facilitate coordinated team-based care.
• Customer Service:
  Provide exceptional customer service to patients with a compassionate and empathetic approach. Address patient concerns professionally and promptly to meet patient needs and ensure satisfaction.
• Administrative Functions:
  Perform general administrative tasks, support other staff, manage assigned buckets and tasks, and use the company s software systems to enhance patient care and staff productivity.
• Collaboration and Coordination:
  Work with internal and external resources to facilitate seamless operations.
• Availability:
  Must be available during normal work hours (additional hours may be required). Must also be able to travel between offices, facilities, etc. and be a licensed driver with a valid, insured vehicle.
• Utilize software systems and update information as required.
• Participate in coaching calls and perform other duties as requested or required in the sole discretion of the Company.

• Take responsibility for own work and assist others to achieve daily success.
• Demonstrate and promote the Company s mission, vision, and values.
• Maintain prompt and regular attendance.
• Adhere to standards of behavior, dress code, policies, and procedures. Attend in-services and meetings regularly.
• Promote a…