Provides social work services to individuals or groups including screening, psychosocial assessment, discharge planning, determination of social work goals, appropriate concrete and/or therapeutic interventions and follow-up. Exercises a substantial degree of professional judgment, recognizing deviations from the usual patient/family functioning, anticipating problems and taking measures to maximize coping capabilities. Conducts initial assessment and establishes a plan of care through psychosocial, financial, functional, and environmental data; establishes and follows a plan of care, which identifies problems and evaluates outcomes. Provides ongoing assessment of patient/family needs and applies appropriate interventions. Updates and revises plan of care as indicated. Plans for discharge from medical social services according to organization standards and utilizes internal systems and community resources to assure patient/family needs are being met. Implements interventions substantiated by assessment as appropriate to the needs of the patient/client system and consistent with available resources. Initiates and coordinates interventions with the activities of other members of the health care team. Collaborates with community agencies and institutions to plan continued care and to coordinate interventions related to finances, housing, childcare, family discord and other psychosocial problems. Provides crisis intervention services. Documents activity according to department and program protocols or standards. Maintains and updates patient records according to organization, state, and federal guidelines. Assists with managing utilization of resources especially as related to patients with complex continuity of care needs. Provides education to patients/families regarding Advance Directives for health care decision-making. Assists with execution of these documents as appropriate. Communicate effectively with patients, family, other members of the health care team and community agencies and facilities resolution of issues which could impact on continuity of care (e.g., prior-approvals, application requirements, transfer paperwork). Communicate with physician, care coordinator, other team members to collaborate and update plan of care. Provides support to patient's family members in the case of a patient's death. Establishes effective professional relationships, positively representing the social work profession throughout the organization and in the community. Promotes constructive approach to problem solving. Adheres to the professions Code of Ethics; consistently practices within a framework guided by ethical principles. Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures. Age-specific information is developed further in the departmental job standards.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Job Type
Full-time
Career Level
Mid Level