Social Worker Family Caregiver Support Program

HonorHealth•Scottsdale, AZ

12d•Onsite

About The Position

HonorHealth is seeking an experienced and visionary social worker to lead the development of a caregiver support program. As the program lead, you will provide emotional support, resource navigation, and education to family caregivers while training and mentoring volunteer caregiver coaches with lived caregiving experience. You will collaborate with interdisciplinary healthcare teams, community partners, and philanthropic stakeholders to create meaningful solutions that empower caregivers and improve patient and family outcomes. This is an exceptional opportunity for a social worker who is energized by both direct practice and building something new. If you are passionate about improving the lives of caregivers and want to build something with lasting impact, we want to hear from you. This is an opportunity to create meaningful change for caregivers while shaping a scalable model of support for the future. Great care starts with great people. (Like you.) At HonorHealth, you’ll find something special. From humble beginnings in 1927 to one of Arizona’s largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most — caring for the health and well-being of people and communities across the greater Phoenix area.

Requirements

Masters in Social Work Required
1 year as a Licensed Social Worker, and/or successful completion of health related field placement in Master's level Social Work Program Required
Licensed Social Worker (LSW) - License Required or
Licensed Clinical Social Worker (LCSW) - License Required or
Licensed Master Social Worker (LMSW) - License Required

Nice To Haves

2 years in case management Preferred
3 years as a Licensed Social Worker Preferred
Other Experience in management of behavioral health patients Preferred
Certified Case Manager - Certification Preferred

Responsibilities

Accountable for an assigned caseload, works collaboratively with patients, caregivers, healthcare providers, and external partners to ensure that care is coordinated and complex information is provided across the health care continuum, resulting in a smooth transition of care with positive patient/family experience, outcomes, high quality, and cost-effective care.
Collaborates with patients/caregivers early in the inpatient, and/or outpatient episode in preparation for discharge to include supportive care, end-of-life decisions, community resources/programs, goal setting, and long-term planning needs.
Interviews, identifies and executes safe post-acute interventions to include pre/post discharge home visits, behavioral health service coordination, guardianship, repatriation, adoptions, CPS, APS, ALTAC, etc.
Assesses readmission risk and barriers to care outpatient including home support, medication management, expectation, etc.
Initiates and assists patients with advance directives.
Facilitates smooth and timely transition from acute care to the appropriate level of care by providing communication of clinical information and plan of care between the hospitalists, specialists and PCP, as well as other key providers.
Communicates financial obligations and other key information pertinent to the discharge plan to the patient, family, MPOA, etc.
Assures effective transition and final hand-off to the next appropriate level acuity case management team.
Communicates key information regarding inpatient stay and discharge plans to payer in order to obtain authorization for services.
Promotes a collaborative process and communication between all health care team members, inclusive patients/clients, families and significant others to ensure the process of integrated care services are targeted, appropriate, and beneficial to the population served from admission through the discharge process.
Participates in the development and maintenance of Case Management metrics.
Maintains and manages to caseload.
May act as a patient advocate through the continuum and is available to the physician, patient and family as a resource to facilitate communication and monitors patient care to ensure that the patient receives quality care through the use of standards of care and evidence based practice guidelines.
Advocates utilizing knowledge of applicable laws, regulations, government and insurance benefits as well as practice guidelines and standards of practice.
Performs other duties as assigned.