Social Work Resource Specialist

NorthBay Health•Fairfield, CA

About The Position

At NorthBay Health, the Resource Specialist (RS) will perform a combination of duties designed to maximize the utilization of hospital resources and coordinate post-hospital care or offer resources and education for patients in support of Social Services, including supporting Inpatient Case Management and Population Health teams per business needs. This RS position is patient-facing and will primarily serve/support the Social Services department but will be cross trained to also support case management and population health RS roles to collaboratively improve patient access and help reduce readmission. The responsibilities of these comprehensive duties include communication and coordination with payers and outside agencies to assist with patient discharge and supporting IPCM/Social Work accountabilities. The Resource Specialist at NorthBay Healthcare must be able to demonstrate adherence to the department and system policies, procedures, quality assurance, guidelines and goals of the department and the organization. The Resource Specialist takes day to day direction for priorities from the Inpatient Case Management/Social Work Supervisor, Social Worker or designee. At NorthBay Health, we are guided by our values: Nurturing Care; Own It; Respect; Build Trust; and Hardwire Excellence. These principles lead us to our TRUE NORTH and inspire us to provide exceptional care. These values serve as the foundation of everything we do, guiding us to deliver individualized care with integrity and accountability. We are committed to fostering a culture of collaboration, where every team member is valued and empowered to contribute their best to the health and well-being of those we serve. This is an exciting time to join NorthBay Health. As an independent, nonprofit health system north of the San Francisco Bay Area, in the Napa/Solano Region, we are expanding our footprint across Solano, Yolo, and Napa counties to meet the evolving needs of our communities. With two acute-care hospitals—including a Level II Trauma Center and a modern maternity unit with a Level III Neonatal Intensive Care Unit (NICU)—along with a comprehensive cancer center, multiple urgent care facilities, and a growing network of primary and specialty clinics, we are investing in the future of care across the region. NorthBay Health we are home to advanced clinical programs and nationally recognized cardiovascular, neuroscience, and orthopedic services, as well as comprehensive surgical and outpatient specialties. Our commitment to excellence is reflected in our Magnet with Distinction designation for nursing (one of only 12 organizations nationwide) and recognition from U.S. News & World Report as “High Performing” in multiple clinical areas, including maternity care, heart failure, and stroke. NorthBay Medical Center has earned the High Performing designation in maternity care for four consecutive years. As the only locally governed health system in the region, we remain deeply rooted in our communities while growing into a trusted regional healthcare leader. If you are seeking meaningful work, collaborative teams, and the opportunity to help shape the future of healthcare in Northern California, you will find it at NorthBay Health. Join us with our commitment to excellence, to achieve our vision to be the trusted healthcare partner of choice for the communities we serve. To learn more about NorthBay Health's benefits, diversity statement and community please visit https://www.northbay.org/careers/

Responsibilities

Maintains regular communication with Inpatient Case Managers (IPCM), Social Workers, appropriate management staff, outside agencies and other hospital departments.
Prepares necessary paperwork for the Social Workers and IPCM.
Provides support to the Social Worker and IPCM: faxing, copying charts, follow-up phone calls, resource education to patients, coordinating Lyft/taxi rides, providing clothes/items to the homeless, tracking of shelter beds, follow-up appointments, with documentation in the EMR system and Navi Health per policies and procedures.
Initiates and documents Advanced Directive paperwork with patients as directed.
Initiates, documents, and tracks provided resources and any items related to discharge planning and disposition (home, shelter, wellness checks, etc.)
Interacts with review organizations, third party payers, and outside agencies to expedite resources for patient discharge plans and maximize hospital reimbursement for services provided. Documents denials, authorizations, and health plan updates in the Electronic Health Record. Appropriately notifies Medical Auditor, Social Worker and/or Supervisor of authorization issues.
Interacts with patients and/or families to provide resource options, as directed.
Verifies insurance benefits and contracted agencies for patient care options post discharge.
Coordinates post-hospital care (SNF, DME, Home Health, Crisis, Shelter bed, etc.) in accordance with the interventions and discharge plan created by the IPCM and/or Social Worker.
Maintains and updates resources on K drive and notifies RS Lead and SW Supervisor of updates.
Attends and participates in patient care rounds, as appropriate.
Upon the request of IPCM or SW, produces and distributes all necessary correspondence.
Produces necessary correspondence, including hospital transfer information, for the IPCM/SW.
Organizational standards for Joint Commission, Department of Human Services, Patient Safety, CMS Conditions of Participation, and the Department of Health will be met.
Performs audits (i.e. Anticipated Discharge Date) as assigned.
Performs special functions and other duties as assigned.