Social Worker Hospital Care Management , Adult, FT

Prisma Health•Greenville, SC

6d•Onsite

About The Position

Provides screening, assessment, planning, problem resolution, resource management, counseling, and crisis management related to patients’ and families’ health care and discharge planning needs. Manages and collaborates on discharge planning for patients with simple and complex needs and coordinates with agencies providing post-hospital care. Works as an interdisciplinary health care team member to assess patient and family needs, develop comprehensive plans of care, and coordinate and facilitate resolution of identified needs. Services are provided in accordance with accepted professional standards and Prisma Health policies and procedures. This is a non-management position reporting to a supervisor, manager, director, or executive. The role is based at Greenville Memorial Hospital in the Hospital Care Management department and works the day shift.

Requirements

Master’s degree in social work.
Currently licensed as a Licensed Master Social Worker (LMSW) or Licensed Independent Social Worker (LISW) by the state Board of Social Work Examiners.
Organizational skills.
Time-management skills.
Crucial-conversation skills.
Problem-solving skills.
Critical-thinking skills.

Nice To Haves

One year of social work experience preferred.
One year of experience in a health care setting preferred.
ACM, CCM, C-SWCM, or ACSW certification preferred.

Responsibilities

Assess patients’ and families’ psychosocial risk factors based on preliminary risk screening, including prior functioning, support systems, reactions to illness, and ability to cope.
Ensure medical-record documentation is legible and complies with hospital and department policies, including screening, initial discharge plans, condition updates, and final discharge plans.
Promote the Hospital Case Management team approach through discharge-planning activities as requested or assessed.
Maintain close communication with post-acute care providers.
Complete readmission assessments, risk-stratification reviews, and action planning.
Use proactive measures to support comprehensive discharge planning.
Screen and coordinate appropriate skilled nursing facility and rehabilitation facility referrals.
Provide consultation to team members regarding clinical needs as appropriate.
Advocate for patient and family empowerment and independence in making autonomous health care decisions and accessing needed services.
Intervene with patients and families regarding emotional, social, and financial consequences of illness or disability, and mobilize family and community resources to address identified needs.
Provide interventions in cases involving child abuse or neglect, domestic violence, elder abuse, institutional abuse, and sexual assault.
Serve as a resource and provide counseling and intervention related to treatment decisions and end-of-life issues.
Participate in developing and implementing Case Management program policies and procedures.
Assess patients’ behavioral health needs in collaboration with physicians, psychiatrists, and other mental health team members.
Provide counseling, crisis intervention, and psychosocial assessments to patients and families with appropriate medical staff supervision.
Perform other duties as assigned.