Part Time Social Worker (MSW)

Fresenius Medical Care•Auburn, ME

About The Position

Provides psychosocial services to patients treated by the facility, including in-center and home dialysis patients when applicable. Uses social work theory and accepted social work methods to support positive adjustment, rehabilitation, and improved quality of life. Works with the healthcare team to explain and address the emotional, psychological, and behavioral effects of chronic kidney disease on patients and families. Supports quality indicators, patient satisfaction and quality-of-life outcomes, quality assessment and improvement activities, and process improvements aimed at helping patients achieve quality goals. The Social Worker assesses psychosocial status, strengths, and needs; collaborates with patients and the interdisciplinary team on care planning; provides monitoring, counseling, education, and referrals; and documents interactions and interventions. The role supports patient education and adherence, treatment-modality information, transplant referral and waitlist management, admission and continuity of care, advance-care planning, and insurance and financial-assistance needs. It also contributes to quality reviews, team huddles, staff education, resource-list maintenance, and hiring activities when requested. Travel is required when multiple facilities are involved. No supervisory responsibilities are listed.

Requirements

Master’s degree in Social Work.
State-required license.
2–5 years of related experience.

Responsibilities

Assess patients’ psychosocial status, strengths, and needs that may affect rehabilitation and treatment outcomes.
Collaborate with patients and the interdisciplinary healthcare team on care planning and interventions to support treatment goals and quality of life.
Use patient education programs, social work methods, focused interventions, and quality-of-life measurement instruments to address barriers and treatment goals.
Monitor patients and provide interventions to support adjustment to dialysis and optimal psychosocial status and quality of life.
Provide supportive counseling within the scope of clinical training and state licensure, and provide goal-directed counseling to patients seeking transplant.
Provide information and referrals to community resources, including home health services and vocational or educational rehabilitation programs.
Assess awareness of advance directives, help patients access forms and information, and facilitate discussions with patients, families, and the care team as needed.
Participate with the physician and nurse in discussions of patient DNR status to support informed decisions.
Follow social work and patient-function policies, including documentation; document interactions and interventions provided to patients and families.
Provide psychosocial support and social-work-focused interventions for non-adherence, quality outcomes, and quality-of-life concerns based on patient acuity.
Participate in monthly interdisciplinary quality reviews and report on adherence indicators, quality-of-life trends, and service recovery.
Assess patients’ kidney-disease knowledge and learning barriers, and tailor education with patients, families, and the care team.
Provide information about treatment modalities, facilitate transplant referrals, and collaborate on transplant waitlist management.
Educate patients and families about psychosocial issues related to ESRD and available support services.
Review patient rights and responsibilities, grievance information, and facility policies with patients or their representatives.
Collaborate with the team on quality assessment and improvement activities.
Review admission materials and address immediate needs or concerns; support referral, admission, and scheduling processes to promote adherence and adjustment.
Interview patients requesting discharge to identify underlying concerns and share them with operational leadership.
Liaise with Insurance Coordinators to address patient insurance issues and educate patients about dialysis payment and assistance programs.
Coordinate with Insurance Coordinators about patient status changes affecting insurance and refer treatment-bill questions to Patient Billing Solutions.
Assist with interviews and hiring decisions when requested by the Social Work Manager or Senior Manager.
Work with administrative support staff to maintain current patient resource lists.
Provide staff training on psychosocial topics as needed and participate in weekly team huddles, discussing urgent patient issues.
Follow caseload guidelines based on state regulatory requirements.
Perform other related duties as assigned.