Social Worker Shea

HonorHealth•Scottsdale, AZ

5d•Onsite

About The Position

The Social Worker is accountable for an assigned caseload and works collaboratively with patients, caregivers, healthcare providers, and external partners to coordinate care and communicate complex information across the healthcare continuum. The role supports smooth transitions of care, positive patient and family experiences, quality outcomes, and cost-effective care. The Social Worker collaborates with patients and caregivers during inpatient or outpatient episodes to prepare for discharge, address supportive care and end-of-life decisions, connect patients with community resources, set goals, and plan for long-term needs. The role assesses readmission risks and barriers to outpatient care, facilitates safe post-acute interventions and transitions to appropriate levels of care, and communicates care plans and relevant information to providers, patients, families, payers, and the next care-management team. The Social Worker promotes integrated, collaborative care, manages a caseload, contributes to case-management metrics, and may advocate for patients throughout the continuum of care. This position is based at Shea Medical Center in Scottsdale, Arizona. The schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m., with weekend rotation availability. A sign-on bonus of up to $5,000 is offered.

Requirements

Master's degree in Social Work required.
At least 1 year as a Licensed Social Worker, or successful completion of a health-related field placement in a master's-level Social Work program.
An active license as a Licensed Social Worker (LSW), Licensed Clinical Social Worker (LCSW), or Licensed Master Social Worker (LMSW).

Nice To Haves

2 years of experience in case management preferred.
3 years of experience as a Licensed Social Worker preferred.
Experience managing behavioral health patients preferred.
Certified Case Manager certification preferred.

Responsibilities

Collaborate with patients and caregivers early in inpatient or outpatient episodes to prepare for discharge, including supportive care, end-of-life decisions, community resources, goal setting, and long-term planning.
Interview patients and identify and execute safe post-acute interventions, which may include home visits, behavioral health service coordination, guardianship, repatriation, adoptions, CPS, APS, and ALTAC.
Assess readmission risk and outpatient barriers to care, including home support, medication management, and expectations.
Initiate and assist patients with advance directives.
Facilitate timely transitions from acute care to the appropriate level of care by communicating clinical information and care plans among hospitalists, specialists, primary care providers, and other key providers.
Communicate financial obligations and other discharge-plan information to patients, families, and medical powers of attorney.
Ensure effective transition and final handoff to the next appropriate level-of-acuity case-management team.
Communicate information about inpatient stays and discharge plans to payers to obtain service authorization.
Promote collaboration and communication among healthcare team members, patients, families, and significant others to support integrated and appropriate care from admission through discharge.
Participate in developing and maintaining case-management metrics and manage an assigned caseload.
May act as a patient advocate throughout the care continuum, serve as a resource to physicians, patients, and families, and monitor care quality using standards of care and evidence-based practice guidelines.
Advocate using knowledge of applicable laws, regulations, government and insurance benefits, practice guidelines, and standards of practice.
Perform other duties as assigned.