Social Worker, Advanced Heart Failure & Organ Transplant, Full-time Days - MSW/LSW Required
Assess, diagnoses, intervenes with and plans for social work services related to patient and family bio-psychosocial needs and behaviors. Integrates assessment using information related to cultural, clinical, ethnic, age and other factors into plan of care in order to implement transition plans and treatments. Acts as active team member in the care management of patients with behavioral health, palliative care and social determinants of health needs. Coordinates the transition through the care continuum to achieve the desired outcome. Refer patients/families and caregivers to appropriate resources regarding abuse/neglect/domestic violence, alcohol and substance use disorder. Performs appropriate clinical interventions related to grief counseling, bereavement, and adjustment, crisis intervention in order to support the care coordination and increase patient/family coping skills. Responsible for the psychosocial assessment, planning, implementation, monitoring and support of patients through the continuum of care. Using appropriate utilization of resources, maintain compliance and achieve cost effective and positive patient outcomes. Utilizes independent critical thinking and collaborates with multidisciplinary team to address patient’s discharge needs and transition into post- acute setting when applicable.
Uses culturally competent skills to assess individual patient needs and refers to appropriate professional staff when necessary. Coordinates appropriate care through psychosocial assessment, multidisciplinary rounds and patient advocacy. Provides clinical social work consultation, ongoing case discussion and evaluation, patient advocacy, clinical goals, and treatment plans, for the purpose of providing individual, group and family psychotherapeutic counseling. Coordinates a broad spectrum of social and planning needs. If applicable, participate and develop inpatient and community programs that benefit patient, families, and staff. Implements support groups for specified disease processes or biopsychosocial issue to assist community outreach and development.
Maintains appropriate and complete documentation of appropriate interventions including assessments, plans and referrals. Follows up on all referrals from the provider for behavioral health, substance use disorder treatment, end of life supportive care and other biopsychosocial needs. Makes appropriate referrals with respect to patient, family and transitional needs. Provides education on available resources and strategies for utilizing or gaining access to resources.
Coordinates appropriate care through psychosocial assessment, multidisciplinary rounds and patient advocacy. Provides clinical social work consultation to physicians, professional staff, and other teams members/supervisors to provide optimal quality patient care and effective operations.
Knowledgeable of public and private welfare and health agencies available to serve the community. Acts as a liaison with community health and social service agencies. Also, possess knowledge of State and Federal hospital compliance. Identifies and reports compliance issues as appropriate.
Position Qualifications Required:
One year of social work experience in a related clinical setting preferred.
Excellent verbal and written communication skills, problem solving, conflict management, organization and planning skills. Demonstrated competence in providing clinical social work services including psychosocial counseling with individuals and families.
Ability to understand medical terminology, diagnostic criteria, with the ability to communicate effectively with persons of diverse backgrounds.
Minimum education of Master’s Degree in Social Work (MSW), from an accredited school of social work.
Training / Certification / Licensure:
Current valid New Jersey State Social Worker License (LSW) required.
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