Social Worker Hospital Care Management , Adult, FT

Prisma Health•Greenville, SC

8d•Onsite

About The Position

The Social Worker provides screening, assessment, planning, problem resolution, resource management, counseling, and crisis management related to patients’ health care and discharge planning needs. The role manages and collaborates on discharge planning for patients with simple and complex needs and coordinates with agencies providing post-hospital care. As an interdisciplinary health care team member, the Social Worker collaborates with health care professionals to assess patient and family needs, develop comprehensive care plans, and coordinate resolution of identified needs. Services are provided in accordance with accepted standards of professional practice and Prisma Health policies and procedures.

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, including prior functioning, adequacy of support systems, responses to illness, and ability to cope.
Document screening results, initial discharge plans, changes in condition, and final discharge plans in the medical record in accordance with hospital policies and procedures.
Promote the Hospital Case Management team approach to discharge planning and maintain communication with post-acute care providers.
Conduct readmission assessments, review risk stratification, develop action plans, and use proactive approaches to comprehensive discharge planning.
Screen and coordinate appropriate referrals to skilled nursing and rehabilitation facilities.
Consult with team members regarding clinical needs, as appropriate.
Advocate for patients’ and families’ empowerment and independence in making health care decisions and accessing services.
Address the emotional, social, and financial consequences of illness or disability and mobilize family and community resources to meet identified needs.
Intervene in cases involving child abuse or neglect, domestic violence, elder abuse, institutional abuse, and sexual assault.
Provide information and counseling related to treatment decisions and end-of-life issues.
Participate in developing and implementing Case Management program policies and procedures.
Assess 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.