Social Worker Jobs

About The Position

Requirements

• Master’s degree in Social Work.
• Must hold the state-required license and meet applicable state board scope-of-practice and licensure requirements.
• 0–2 years of related experience.

Responsibilities

• Assess patients’ psychosocial status, strengths, and needs that may affect rehabilitation and treatment outcomes as part of comprehensive patient assessment.
• Collaborate with patients and the healthcare team on care planning and effective interventions to support rehabilitation, treatment goals, and quality of life.
• Use patient education programs, social work theory and methods, focused interventions, and quality-of-life measurement instruments in assessment and care planning.
• Monitor patients and provide interventions to support adjustment to dialysis and optimal psychosocial status and quality of life.
• Provide supportive counseling within the scope of clinical training and state licensure.
• Provide education and goal-directed counseling to patients seeking transplant.
• Refer patients to community resources, including home health services and vocational rehabilitation.
• Maintain knowledge of local vocational and educational rehabilitation programs and assist patients with referrals and access.
• Assess patient awareness of advance directives and help patients access information and discuss their wishes with the healthcare team and family or support persons when needed.
• Participate with the physician and nurse in discussions of patient DNR status to support informed decisions by patients and/or families.
• Follow FMCNA Social Work Policy and Measuring Patient Physical and Mental Function Policy, including documentation requirements.
• Document interactions and interventions provided to patients and/or families.
• Provide psychosocial support and social work interventions addressing non-adherence, quality outcomes, and quality-of-life concerns according to patient acuity.
• Participate in monthly interdisciplinary quality review meetings and report on adherence indicators, missed and shortened treatments, quality-of-life trends, and service recovery.
• Assess patients’ kidney disease knowledge and barriers to treatment adherence; tailor education to patients’ learning styles, communication barriers, and needs.
• Provide information about treatment modalities with other interdisciplinary team members.
• Facilitate transplant referrals and collaborate with the interdisciplinary team on transplant waitlist management.
• Educate patients and families about psychosocial issues related to ESRD and available support services.
• Review patient rights and responsibilities, grievance information, and facility policies with patients or their representatives.
• Collaborate with the team on quality assessment and improvement activities.
• Review required rights, grievance, non-discrimination, DNR (if applicable), and contact information with patients at admission, and address immediate needs and concerns.
• Support the clinic’s referral and admission process, including scheduling to maximize adherence and adjustment.
• Interview patients requesting discharge to identify underlying concerns and share them with operational leadership.
• Liaise with insurance coordinators to address patient insurance issues and educate patients about dialysis payment sources and assistance programs.
• Notify insurance coordinators of patient status changes affecting insurance, including transplantation, discharge, loss of coverage, or extended travel.
• Refer patients to the Patient Billing Solutions department for treatment-related billing questions or concerns.
• Assist with interviewing and hiring decisions for personnel when requested by the SW Manager or Senior Manager.
• Work with administrative support staff to maintain current patient resource lists, such as transportation resources.
• Train staff on psychosocial topics as needed.
• Participate in weekly team huddles and discuss urgent patient issues with staff.
• Adhere to caseload guidelines based on state regulatory requirements.
• Perform other related duties as assigned.