Social Worker- Hospital

HealthPartners•Hutchinson, MN

2h•$29 - $43•Onsite

About The Position

The Social Worker provides patient-centered care management services to patients and families in an inpatient hospital setting. This position serves as an integral member of the interdisciplinary healthcare team and is responsible for identifying care coordination needs in collaboration with the inpatient and ambulatory care teams, along with the patient and the patient’s external support systems. Within the context of an interdisciplinary team, the Social Worker participates in progressing patients toward discharge/next level of care by identifying barriers, implementing appropriate interventions, and securing transition plans that are aligned with shared goals of care. The Social Worker will consistently and thoughtfully apply social work values and continuous quality improvement in daily work.

Requirements

BSW- Bachelor’s of Social Work
Active Licensed Social Worker (LSW) license with the Minnesota Board of Social Work
Knowledge of the values, principles, and methodologies of social work
Exceptional organizational and time management skills

Nice To Haves

Previous discharge planning in hospital setting, social work experience in long-term care or hospice

Responsibilities

Conducts thorough and accurate psychosocial assessments in a timely manner with a patient-centered approach.
Interviews patients, focusing on relevant issues related to life situation, community supports, medical needs, barriers to care and areas of opportunity/need.
Obtains collateral information from family and community supports as appropriate.
Ensures timely progression of care with proactive identification and elimination of potential delays/barriers in patient care. Escalates barriers to hospital leadership for system resolution.
Ensures all care coordination is patient-focused, incorporating cultural needs and respect for diverse patient populations.
Actively works with interdisciplinary team to develop and implement care plans during hospitalization.
Establishes and implements care plans to ensure safety, continuity of care, appropriate care coordination and support post-hospitalization, working with community providers and resources as appropriate.
Organizes and attends care conferences when appropriate.
Uses knowledge of community resources, healthcare funding, along with county, state, and federal regulations in making appropriate and safe plan.
Communicates promptly, clearly, respectfully and effectively with care team, patient and support system.
Completes assessments and participates in care rounds to ensure critical interventions and procedures occur to achieve optimal patient outcomes.
Documents work clearly, concisely and consistently in a timely manner using appropriate standardized format in the electronic medical record. Submits changes when appropriate.
Maintains confidentiality of information in accordance with department and organization policies.
Utilizes tools and technology to identify and intervene with patients who are at risk for readmission and to ensure medically appropriate length of stay.
Facilitate psych-education groups on inpatient mental health.
Educates patients and families within the context of the psychosocial assessment.
Educates bedside nurses, physicians and healthcare staff informally in the context of patient discussion.
May provide formal education through presentations at conferences, meetings, etc. when applicable.
Content of education includes but is not limited to: medical issues, available post-acute support for follow up needs, health care funding, community resources, barriers to discharge, health care directives, establishment of legal decision-maker, social determinants of health, and psychosocial impact of illness.
Maintains excellent working relationships with interdisciplinary team members, patient care units and community resources.
Functions independently as a part of an interdisciplinary team, working effectively within departmental expectations as well as with patients, patients’ support systems, and the medical team to facilitate quality and efficient patient care.
Works collaboratively with departmental colleagues to best meet patient medical/psychosocial and discharge needs.
Enhances departmental relationships and activities through active participation in staff meetings and proactively identifying problems and solutions in the work environment.
Supports other team members in achieving patient-centered goals.
Participates in and contributes to appropriate departmental and/or organizational meetings.
Remains current in social work practices and best practices in the fields of healthcare and care coordination. Shares knowledge gained from attending outside educational opportunities with departmental and hospital teams.
Demonstrates responsiveness to and appreciation of constructive feedback and recommendations for personal growth and development.
Maintains current, active Minnesota licensure.
Maintains regular and timely attendance.
Completes all mandatory education and organization requirements in a timely manner and actively demonstrates self-directed learning and continuing education to enhance professional development.
Assists in identifying educational opportunities for personal and departmental learning and development.
Willingly participates in various committees, task forces, projects, and quality improvement teams, as needed and assigned. Performs other duties as assigned.