Social Worker, Transplant, Per Diem, 1st shift, Camden

Virtua Health

7d•$70,935 - $110,268•Onsite

About The Position

The Social Worker provides ongoing psychosocial support and navigation services to patients with advanced organ disease, transplant candidates and recipients, mechanical circulatory support candidates and recipients, living donors, and caregivers throughout all phases of care. The role spans inpatient and outpatient settings and collaborates closely with multidisciplinary care teams. It includes regulatory-compliant documentation and availability after hours as needed for emergent evaluations and candidate selection meetings. The Social Worker also provides counseling, crisis intervention, community referrals, education, bio-ethics consultation, and complex discharge-planning coordination. Services are delivered compassionately and in a culturally competent, age-appropriate manner to facilitate access to transplantation and advanced care services. The position participates in multidisciplinary rounds and selection meetings, as well as outreach initiatives that educate patients and the community about transplantation and advanced care disease services. The schedule is Tuesday, Wednesday, and Thursday, consisting of eight-hour days as needed. This is a per-diem, part-time, on-site position based in Camden, New Jersey, with an additional location listed at 1105 Laurel Oak Rd. #166. The role maintains a cumulative patient caseload and coordinates care and support across inpatient and outpatient settings.

Requirements

Two to three years of healthcare experience focused on transplant, chronic illness, or advanced organ disease in inpatient and outpatient settings.
Strong understanding of the complex and ongoing needs of transplant and advanced organ disease patients.
Proficiency in care navigation, crisis intervention, discharge planning, and managing cumulative caseloads.
Excellent verbal and written communication, problem-solving, conflict-management, organization, and planning skills.
Demonstrated competence providing clinical social work services, including psychosocial counseling for patients and families in high-stress situations.
Ability to understand medical terminology and diagnostic criteria and communicate effectively with people from diverse backgrounds.
Master’s Degree in Social Work (MSW) from an accredited school of social work.
Current valid New Jersey State Social Worker License; LCSW required.

Nice To Haves

A valid driver's license may be required.

Responsibilities

Conduct comprehensive, culturally competent psychosocial assessments in inpatient and outpatient settings, addressing patient needs, family dynamics, social histories, and financial needs, and develop individualized care plans.
Interview family members and others to obtain information relevant to patient assessment and care planning.
Communicate pertinent psychosocial information to transplant and advanced organ disease teams and referral sources.
Provide supportive counseling to patients and families and coordinate referrals to psychiatry or behavioral health when needed.
Participate in and develop inpatient and community programs, including support groups for specified disease processes or biopsychosocial concerns.
Maintain complete psychosocial assessment, intervention, plan, and referral documentation; follow up on referrals for behavioral health, psychiatry, substance use disorder treatment, end-of-life supportive care, and other needs.
Make appropriate referrals for patients, families, and transitions of care, and educate them about available resources and how to access them.
Assist patients with advanced care planning and facilitate palliative care or hospice consultations when clinically indicated.
Advocate for patients and families throughout the continuum of care.
Maintain a cumulative caseload and continually assess needs for emotional support, financial and medication assistance, lodging, and other community resources.
Follow up with patients through ongoing check-ins, monitor psychosocial needs, and update care plans.
Prioritize and balance patient psychosocial needs according to acuity and complexity in collaboration with clinical teams.
Regularly update the team on patient progress and changes across the care continuum.
Serve as a primary contact for patients and families, coordinating resources across inpatient and outpatient settings and phases of care.
Participate in multidisciplinary case discussions, discharge rounds, and chart reviews to formulate discharge plans.
Collaborate with physicians, nurses, coordinators, dietitians, pharmacists, financial coordinators, and other team members.
Coordinate follow-up appointments, home health referrals, and other outpatient resources.
Develop discharge plans with clinicians, the interdisciplinary care team, and outcomes managers to connect patients with outpatient and community follow-up and resources.
Guide outpatients through transplant and mechanical circulatory support evaluations and selection processes, including support for medication, finances, and housing needed for recovery after procedures.
Educate patients and families about transplant and advanced organ disease management.
Provide or assist with in-service education and orientation for new and existing staff.
Participate in clinical research on psychosocial aspects of transplantation, living donation, and advanced organ disease, and work toward publication or presentation at local and national meetings.
Offer workshops, group sessions, and individual counseling to help patients and caregivers adapt to quality-of-life changes.
Facilitate support groups that provide opportunities for shared experiences and coping strategies.
Document patient assessments, encounters, interventions, and care plans in compliance with hospital policies and state and federal requirements.
Ensure documentation meets applicable regulatory standards and track and report psychosocial indicators for compliance, quality assurance, and performance improvement.
Participate in multidisciplinary rounds, selection meetings, and outreach initiatives; be available after hours as needed for emergent evaluations and candidate selection meetings.