Medical Social Worker

University of Vermont Health Network

6d•$33 - $50•Onsite

About The Position

The Medical Social Worker (MSW) III is an integral member of the interdisciplinary care team, providing social work and care management services to patients and families in home care and/or hospice settings. The role helps address psychosocial factors that may impede treatment, recovery, or achievement of health and end-of-life care goals, in accordance with the plan of care. The position manages a home-visiting caseload of patients with diverse and complex needs. It conducts psychosocial assessments, develops and coordinates care plans, provides counseling and crisis intervention within professional scope, and connects patients and families with health care and community resources. The Medical Social Worker collaborates with patients, caregivers, families, interdisciplinary teams, and external organizations, and documents services and mandated reports in accordance with applicable policies and regulations. In hospice, the role may provide services in patients’ homes or a hospice facility, supervise day-to-day tasks of other interdisciplinary team members, and provide bereavement support. An APHCSW and LICSW hospice social worker should be able to perform independent palliative care assessments. The position reports to the Clinical Manager; clinical supervision for triage and coordination of complex issues is provided by the MSW Lead. This is a per diem position with no committed hours and no benefits eligibility. The listed shift is day, with a primary shift of 8:00 AM–4:30 PM and no weekend needs. Travel is required. Work may occur in community settings, clients’ homes, and outdoors, and may take place during non-business hours. The role may involve emotionally upset people, occupational stress, exposure to blood-borne pathogens, and varied environmental conditions.

Requirements

Master’s degree in Social Work.
Five years of relevant experience, or a combination of education and experience providing comparable knowledge and skills; at least three years of health care experience is required.
Vermont LMSW and LICSW licensure required.
Able to speak, read, and write in English.
Honesty, self-direction, initiative, and sound judgment in daily activities.
Clear and effective oral and written communication skills.
Skill in building rapport, providing supportive counseling, and conducting medical interviews.
Ability to work cooperatively and productively with internal and external customers.
Maintain good standing with required regulatory bodies and law enforcement agencies.
Valid driver’s license and reliable transportation; travel is required.
Knowledge of social work and care management standards of practice, insurance structures, Medicare and Medicaid rules, clinical practice guidelines, and quality issues related to home health or hospice care.
Understanding of barriers and resources available to diverse populations and gaps in service delivery systems for the population served.
Ability to provide crisis intervention involving risks such as abuse, neglect, environmental stressors, suicide, guardianship or conservatorship issues, long-term planning, and unsafe home environments.
Facilitation skills and knowledge of team and small-group principles and dynamics.
Ability to explain medical problems and treatments accurately and understandably, and identify communication barriers to patients achieving health care goals.
Ability and commitment to build honest, trustworthy relationships.
Skills and knowledge to assess and provide case management across the continuum of care, applying human growth and development principles and helping patients and families cope with illness, psychosocial challenges, disability, terminal illness, loss, and grief.
Understanding of one’s own culture, beliefs, identity, values, and biases and how these affect interpersonal style.
Working knowledge and experience with medical and mental health diagnoses, disabilities, treatment procedures, acute, chronic, and traumatic illnesses, substance abuse disorders, common medications and their effects and side effects, and medical terminology.
Working knowledge of mandated reporting requirements for suspected abuse and neglect of vulnerable adults and children.
Ability to travel and work in community settings, clients’ homes, and outdoors; the position may require work during non-business hours.
Ability to walk, sit, stand, bend, lift, and move intermittently during working hours.
Ability to push, pull, and lift from the floor up to 50 pounds and move while carrying that weight, in accordance with organizational standards.
Ability to climb stairs of varying heights and degrees and maintain balance.
Ability to kneel, crouch, stoop, twist, reach below the waist, overhead, and at torso level.
Manual finger dexterity to perform duties and use equipment.
Sufficient visual acuity to drive, use office equipment, and perform duties.
Sufficient auditory acuity to assist individuals in person and by telephone.

Responsibilities

Conduct comprehensive initial in-home psychosocial assessments, including assessment of patients’ adjustment to illness and barriers to treatment participation.
Document relevant medical and psychosocial history, health behaviors, beliefs and values, finances, environment, development, functional status, legal issues, medical status, and level of care.
Use assessment findings to support treatment engagement and independence through skilled services, treatment planning, crisis intervention, and counseling within professional scope and competence.
Manage a home-visiting caseload, including admitting clients to MSW skilled services and scheduling visits.
Identify health care and community resources and collaborate with patients, caregivers, families, and multidisciplinary care teams to develop plans of care and relevant goals.
Coordinate care with interdisciplinary teams and external organizations, government agencies, physicians, and other health care providers; provide education about illness, disability, palliative care, and end-of-life care.
Facilitate, coordinate, or participate in multidisciplinary care conferences, rounds, and family meetings as appropriate.
Maintain knowledge of regulatory and legal requirements, including HIPAA, Medicaid, and Medicare Conditions of Participation.
Develop and maintain knowledge of community partners and resources.
Document assessments, care plans, interventions, and clinical and administrative information accurately and within required timeframes; file mandated reports in accordance with Vermont regulations and law.
Assess, plan, intervene, monitor, and evaluate client and patient needs, recommending interventions for complex psychosocial and medical situations.
Collaborate with the interdisciplinary team, make referrals for consultation and services, and support progression of care in accordance with guidelines and protocols.
Under the clinical supervision of the MSW Lead, triage and coordinate care for complex medical and psychosocial issues.
Attend required meetings and sessions related to collaboration, policy and procedure updates, and quality improvement.
Promote a respectful and collaborative environment when addressing conflict and change.
Work with the MSW Lead to research and develop written materials and instructional programs to improve staff knowledge and skills in psychosocial aspects of patient care.
Provide peer support and case consultation for the social work team.
Participate in training new home health staff on the social work role under the direction of the Lead MSW.
Participate in orientation, training, and professional development activities to maintain relevant clinical and technical knowledge.
Consult with the social work lead, senior staff, director, and supervisors to exchange information, coordinate care, consult on cases, and address unusual situations.
In hospice, services may include supervising day-to-day tasks of other interdisciplinary team members and providing bereavement support in accordance with hospice conditions of participation.
Adhere to the University of Vermont Health Network Code of Conduct and safety practices, rules, policies, and standards.
Meet position requirements for schedule, time off, attendance, and accurate reporting; maintain licensure competencies and pursue continued learning and professional growth.
Perform other related duties as designated by the manager.