Community Outreach Social Worker

FAMILY HEALTH CARE CENTER OF KALAMAZOO•Kalamazoo, MI

6h•Onsite

About The Position

Assists individuals and groups with personal, social, emotional, and environmental difficulties which predispose illness or interfere with obtaining maximum benefits from medical care. Staff supports providers through an integrated approach to care management and community outreach. Develops individualized plans of care with targeted interventions; monitors patients and family responses to the plan of care and adjusts as needed. Specific focus is directed to Healthcare for the Homeless, Prison Re-entry, and those with Substance Use Disorders. Provides ongoing case management services for those in need of this level of support.

Requirements

Bachelors of Social Work or other Human Service Field and minimum of two plus year's related experience and/or training; or equivalent combination of education and experience.
Must have experience with mental health and substance abuse.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
Ability to deal with problems involving multiple variables in standardized situations.
Have the ability to effectively communicate with all people regardless of socioeconomic status, ethnicity, and education level.
Professional phone skills required.
Must be familiar with a variety agency programs that serve our client population.
Knowledge of Microsoft Office utilizing Excel Spreadsheet software and Word processing software.

Nice To Haves

Master's Degree Preferred.
Prefer the ability to speak both English and Spanish.
Knowledge of medical terminology preferred but not required.
Knowledge of Medicaid is a plus.

Responsibilities

Performs assessments and provide case management for homeless individuals seeking services at the Family Health Center.
Coordinates with community agencies to assure that linking, monitoring, and coordinating occurs in regards to preventative services for individuals served.
Reaches out to locate individuals to help schedule their services and appointments both telephonically.
Communicates with health care team members and agencies to obtain pertinent information to be utilized in evaluating patient needs.
Provides patients with self-management tools and support to enhance their ability for self-care.
Maintains required documentation for all case management activities.
Coordinate and provide early intervention services for those exhibiting signs of substance use disorders who may not be amenable to treatment services or who do not meet diagnostic criteria.
Prepares case histories for use in diagnosis and treatment. Develops intervention and treatment plans which include an evaluation of family support, patient strengths, and level of risks. Make referrals as needed based on the evaluations.
Works in close collaboration with physicians and other health care personnel in patient evaluation and treatment to further their understanding of significant social and emotional factors underlying patient's health problem.
Identifies patients at risk for development for further issues and locates additional Family Health Center or community services best designed to meet their needs.
Develops comprehensive person-centered treatment plans in conjunction with patients to meet their social, emotional, and behavioral needs. May assist in obtaining authorizing for these additional services.
Helps patient(s) through individual or group sessions to understand, accept, and follow medical recommendations. Follows through on treatment plan in patient's records.
Participates as member of multi-disciplinary team as needed.
Maintains required case documentation and records delivered services in an accurate and timely manner as required by regulating entities, accreditation organizations, and management.
Attends required in-service, departmental, and organizational meetings. Participates in clinical review of cases.
Reviews Current literature on engagement and communication strategies and incorporates best practices into the clinical setting.
Participates in community collaborative as necessary.