Master Social Worker - MSW

Fresenius Medical Care•Lafayette, LA

About The Position

Provides psychosocial services to patients receiving in-center and, where applicable, home dialysis. Uses social work theory and accepted social work practices to promote positive adjustment, rehabilitation, and improved quality of life. Collaborates with the interdisciplinary healthcare team to help staff understand the emotional, psychological, and behavioral effects of chronic kidney disease on patients and families, and supports quality indicators, outcomes, quality assessment and improvement activities, patient satisfaction, and quality-of-life goals. The role also supports patient assessment and care planning, counseling, education, referrals, continuity of care, insurance-related assistance, and staff education. Travel may be required when supporting multiple facilities.

Requirements

Master’s degree in Social Work.
State-required license.
2–5 years of related experience.

Responsibilities

Assess patients’ psychosocial status, strengths, and needs that may affect rehabilitation and treatment outcomes as part of the comprehensive patient assessment.
Collaborate with patients and the healthcare team on care plans and interventions to support rehabilitation, treatment goals, and quality of life.
Use patient education programs, social work methods and interventions, and quality-of-life measurement instruments to assess needs and address barriers to treatment goals.
Monitor patients’ adjustment to dialysis and provide interventions to support psychosocial status 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 transplantation.
Connect patients and the care team with community resources, including home health services and vocational rehabilitation.
Maintain knowledge of local vocational and educational rehabilitation programs and assist patients with referrals and access.
Assess patient awareness of advance directives and assist with information, forms, and discussions with the care team and family or support persons.
Participate with the physician and nurse in discussions of patient DNR status to support informed decisions by patients or families.
Follow social work and patient physical and mental function policies, including documentation; document interactions and interventions provided to patients or families.
Provide psychosocial support and social work interventions addressing non-adherence, quality outcomes, and quality-of-life concerns according to patient acuity.
Participate in monthly interdisciplinary quality review meetings and report on adherence indicators, missed or shortened treatments, quality-of-life trends, and service recovery.
Assess patients’ kidney disease knowledge and barriers to treatment adherence, and coordinate education tailored to their learning styles, communication barriers, and needs.
Provide information about treatment modalities and ongoing education to patients and families about psychosocial issues related to ESRD and available support services.
Facilitate transplant referrals and collaborate with the interdisciplinary team on transplant waitlist management.
Review patient rights and responsibilities, grievance information, and facility policies with patients or their representatives.
Review admission materials and address immediate patient needs or concerns.
Support the clinic’s referral and admission process, including scheduling needs that may affect adherence and adjustment.
Interview patients requesting discharge to identify underlying concerns and share them with operational leadership.
Liaise with Insurance Coordinators to address insurance issues and provide information about dialysis payment sources and assistance programs.
Inform Insurance Coordinators of patient status changes that may affect insurance, such as transplantation, discharge, loss of coverage, or extended travel.
Refer patients to the Patient Billing Solutions department for questions or concerns about treatment-related bills.
Assist with interviewing and hiring decisions for new personnel when requested by the SW Manager or Senior Manager.
Work with administrative support staff to keep patient resource lists, such as transportation resources, up to date.
Train staff on psychosocial topics as needed and participate in weekly team huddles, discussing urgent patient issues.
Follow caseload guidelines defined by state regulatory requirements and perform other related duties as assigned.