Medical Social Worker (LMSW), Inpatient Care Coordinator (PRN)

UT Southwestern Medical Center•Dallas, TX

1d•Onsite

About The Position

The social worker Care Coordinator is a member of the Care Coordination Department who educates the healthcare team and physicians about psychosocial issues and any identified patient/family problems as well as strategies to address the issues. Applies specialized knowledge and advanced practice skills in assessment, treatment, planning, implementation and evaluation, case management, mediation, counseling, supportive counseling, direct practice, information and referral, supervision, consultation, education, research, advocacy, community organization and developing, implementing and administering policies, programs and activities. This position integrates national standards for case management scope of services including: Care Coordination, Compliance, and Transition Management. Care Coordinators will arrange/ensure all elements of the transition plan are implemented and communicated to key stakeholders including, but not limited to, the health care team, patient/family/caregiver, and post-acute providers. Care Coordinators will convey all necessary information for continuity of care and patient safety, verify receipt and provide a venue for additional questions and/or information requests/needs.

Requirements

(LMSW) LIC MASTER SOCIAL WORKER licensed in the state of Texas.

Nice To Haves

2 years hospital experience

Responsibilities

Screens and evaluates high risk patients for discharge planning needs.
Consults with attending physicians and members of the healthcare team regarding any identified psychosocial issues and/or care transition barriers.
Recognizes that the transition process is collaborative with the multidisciplinary team to include the patient/family and assists with executing the plans and interventions to facilitate the hospital stay and manage length of stay and reassesses as care needs change.
Facilitates patient care conferences as indicated, to include complex cases to proactively assist with establishing a safe and effective discharge plan.
Implements the transition of care plan to the next level through appropriate service referrals and assures that the patient is given choice in regards to agencies and services.
Assists with adoptions, abuse and neglect cases, including assessment and investigation, intervention and referral as appropriate to local, state, and/or federal agencies, as indicated.
Educates and provides information and resources to patients and families regarding the availability of community resources.
Interprets patient and family needs and provides information concerning availability and limitation of resources.
Maintains open communications with community agencies to appropriately assist in referring and meeting patient needs.
Maintains knowledge of payor benefits, hospital and community resources, and regulatory standards to ensure informed decision making, continuity of care, and desired outcomes (i.e. medical, medical cost, quality of life, and patient satisfaction).
Maintains chronological notes, clinical charts, statistical data, or case histories for each patient with respect to social problems, adjustments for patient and family involvement, and actions taken or planned.
Performs other duties as assigned.