Master Social Worker - MSW

Fresenius Medical Care•New York, NY

3d•$32 - $53

About The Position

The Master Social Worker provides psychosocial services to in-center and, where applicable, home dialysis patients. Using social work theory and accepted practice methods, the role supports patients’ adjustment, rehabilitation, treatment outcomes, and quality of life. The social worker collaborates with the interdisciplinary health care team to help staff understand the emotional, psychological, and behavioral effects of chronic kidney disease on patients and families, and contributes to quality assessment, improvement, patient satisfaction, and quality-of-life initiatives. The position assesses patients’ psychosocial needs and strengths, participates in care planning, provides counseling and education within the scope of clinical training and state licensure, and connects patients with community, vocational, educational, transplant, and other support resources. It also supports patient education and continuity of care, addresses insurance and financial-assistance questions in coordination with relevant staff, and provides psychosocial training to staff as needed. The role requires working at both Avantus Harlem Green and Upper Manhattan Dialysis Center and travel between facilities.

Requirements

Master’s degree in Social Work.
State-required license.
2–5 years of related experience.
Must be willing to work at both Avantus Harlem Green and Upper Manhattan Dialysis Center.

Responsibilities

Assess patients’ psychosocial status, strengths, and needs that may affect rehabilitation and treatment outcomes.
Collaborate with patients and the interdisciplinary health care team on care plans and interventions that support treatment goals and quality of life.
Use patient education programs, social work methods and interventions, and quality-of-life measurement instruments to identify and address barriers to treatment goals.
Monitor patients’ adjustment to dialysis and provide interventions to support psychosocial well-being and quality of life.
Provide supportive counseling within the scope of clinical training and state licensure, and goal-directed education and counseling for patients seeking transplant.
Connect patients with community resources, including home health services and vocational or educational rehabilitation programs.
Assess patient awareness of advance directives, provide access to related information and forms, and facilitate discussions with the health care team and family or support persons when needed.
Participate with the physician and nurse in discussions of patient DNR status to support informed decisions.
Document patient and family interactions and interventions in accordance with applicable social work policies.
Provide psychosocial support and focused interventions related to adherence, quality outcomes, and quality-of-life concerns.
Participate in monthly quality review meetings and report on indicators such as missed or shortened treatments, quality-of-life trends, and service recovery.
Assess patients’ kidney disease knowledge and barriers to adherence, and coordinate education tailored to their learning style, communication barriers, and needs.
Provide information about treatment modalities and collaborate on transplant referrals and waitlist management.
Educate patients and families about psychosocial issues related to ESRD and available support services.
Review patient rights and responsibilities, grievance information, and facility policies with patients or their representatives.
Collaborate with the team on quality assessment and improvement activities.
Review admission materials and address immediate patient needs or concerns.
Support the clinic’s referral and admission process, including scheduling considerations that promote adherence and adjustment.
Interview patients requesting discharge to identify concerns or root causes and share them with operational leadership.
Liaise with insurance coordinators to address patient insurance issues and provide information about dialysis payment and assistance programs.
Coordinate with insurance staff regarding patient status changes that may affect coverage, and refer treatment-billing questions to the patient billing solutions department.
Work with administrative support staff to keep patient resource lists, such as transportation resources, up to date.
Provide training to staff on psychosocial topics as needed and participate in weekly team huddles, raising urgent patient issues.
Follow caseload guidelines based on state regulatory requirements and perform other related duties as assigned.