MSW Inpatient Care Management

Jefferson Health PlansLansdale, PA
Onsite

About The Position

Provides social work services, assesses and enhances the patient’s/family’s/significant other’s ability to cope with physical, emotional and environmental problems related to illness/convalescence and discharge plan. Works collaboratively with the multidisciplinary healthcare team to establish a discharge plan for the patient.

Requirements

  • Graduate from an accredited Masters of Social Work program required.
  • Masters of Social Work required.
  • Minimum of 2 years hospital based social work experience.
  • Active LSW or LCSW required for New Jersey positions and preferred for Pennsylvania positions.

Nice To Haves

  • Active LSW or LCSW preferred for Pennsylvania positions.

Responsibilities

  • Conducts psychosocial assessment/reassignment of patients/significant others relating to the social, emotional and cognitive capabilities of patients in relationship to their illness and health maintenance needs.
  • Develops and implements a plan of intervention that addresses identified needs related to needs/problems identified during assessment.
  • Collaborated with the multidisciplinary team to ensure appropriate discharge planning.
  • Provides counseling for patient/family/significant others to assist with coping with new diagnoses, chronic illness and palliative or terminal care.
  • Advocates on behalf of the patients/families to enable them to obtain necessary services.
  • Serves as a resource and provides counseling and intervention related to treatment decisions and end of life care issues.
  • Refers patient/significant other to community based services/resources to meet patient’s continuum of care needs.
  • Coordinates team and/or family conferences when necessary to facilitate patient’s care progression.
  • Provides psychosocial counseling and crisis interventions to patients/significant others with needs.
  • Provides interventions in cases involving child abuse/neglect, domestic violence, elder abuse and institutional abuse.
  • Provides intervention in cases involving guardianship, foster care, adoption, psychiatric assessment and placement, Advance Directives (Center City), trauma and substance abuse.
  • Facilitates completion of all placement related documentation in nursing home grants, applications, etc.
  • Completes referrals to options programs where appropriate.
  • Documents in accordance with hospital and departmental requirements.
  • Works with Case Managers in providing discharge planning services per departmental policies and procedures in collaboration with the multidisciplinary team and patient/family.
  • Identifies patients and locates family and/or next of kin.
  • Educates patients/significant others on the process for obtaining health insurance.
  • Provides appropriate documents/information to apply for welfare insurance.
  • When necessary, initiates medical assistance application in a timely manner (Center City) or ensure medical assistance application has been initiated by identified external agencies (excludes Center City).
  • Follows up with identified external service regarding application.
  • Provides psychosocial assessment and intervention as well as documents in the electronic medical record updates throughout patient’s hospitalization, discharge planning process and relevant post-acute care.
  • Supervises field placement of MSW students.
  • When appropriate, refer case to the Placement Official Social Worker to assist in obtaining placement for the patient’s discharge (Center City and Abington/Lansdale).
  • Precept and mentor new staff members to their role and department.
  • Facilitates and coordinates discharge plans for patient identified to leave on the weekend, including homecare/hospice services; transportation; post-acute facility placements.
  • Perform assessments and develops relevant interventions specifically for trauma patients (Abington).
  • Obtains relevant post-acute authorizations.
  • Manages Livanta appeal determinations and if necessary address alternate discharge plans.
  • Provides updates to post-acute facility liaisons regarding possible weekend discharges.
  • Reviews discharge orders to determine which patients can be transitioned to the next level of care that day (JNE).
  • Assist with completing relevant 302 paperwork, when necessary.
  • Documents updates for the week day staff per department procedures.

Benefits

  • medical (including prescription)
  • supplemental insurance
  • dental
  • vision
  • life and AD&D insurance
  • short- and long-term disability
  • flexible spending accounts
  • retirement plans
  • tuition assistance
  • voluntary benefits
  • tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
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