Social Worker-HH-MSW

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Collaborates with the physician, other health care professionals, patient family in the design and documentation of an explicit home health plan of care. Implements and evaluates the progress of the plan of care. Collects key data elements which describe the achievement of quality/performance improvement and utilization/financial goals.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. Master's Degree in Social Work from an accredited school of social work.

2. Current licensure to practice Social Work in the appropriate state where services will be provided.

3. Must possess valid WV or neighboring state driver's license and must maintain WV or neighboring state minimum auto insurance

4. CPR certification within 30 days of hire date.

PREFERRED QUALIFICATIONS:

EXPERIENCE:

1. Two (2) years of Home Health experience.

2. Experience with counseling individuals or groups.

3. Experience with psychosocial, emotional, and spiritual assessment.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an exhaustive list of all responsibilities and duties. Other duties may be assigned.

1. Completes comprehensive assessment to develop a safe, realistic discharge plan of care appropriate for the patient.

2. Assesses changes in the physician's plan of care and the impact on the discharge plan. Initiates discharge planning in collaboration with care team.

3. Reviews discharge plan on an ongoing basis and communicates changes in the plan to the appropriate parties.

4. Documents discharge plan in patient's chart on a frequency that communicates the plan to interdisciplinary team.

5. Ensures that discharge needs are met prior to discharge.

6. Assesses for signs and symptoms of abuse and/or neglect and makes referrals to appropriate agencies.

7. Identifies decision maker of medical (financial, if indicated) or if there is an existing Medical Power of Attorney designee and presence of Living Will or other advanced directives. Assists patient in completion of Living Will and Medical Power of Attorney forms as requested.

8. Works with legal counsel in pursuing and expediting guardianship, and/or conservatorship actions when necessary.

9. Assists in planning, implementing and evaluating QI strategies.

10. Provide care, based on physical, psychosocial, communication, safety, education level, and related criteria for the infant, pediatric, adolescent, adult, geriatric patient per the established age-specific standard.

11. Communicates to leadership and/or appropriate physician/medical staff director/peer review. Deviations from expected norm, quality or appropriateness of care according to established standards of care. Risk management issues.

12. Explains to physicians, patient, family and other health care professionals Medicare, Medicaid and other 3rd party payers coverage issues and regulations.

13. Identifies potential problems with post-discharge care and/or initiates early referrals to promote timely transfer and proper utilization of resources.

14. Takes appropriate actions to minimize financial loss to the organization and/or improve the quality of patient care delivery (i.e., discusses cases with patients and families, consult with physician).

15. Formulate and execute a safe discharge plan in an expeditious manner.

16. Performs needs assessments reflecting patient/family psychosocial, emotional, spiritual, financial, and age-specific criteria upon admission and each visit thereafter, including development of an interdisciplinary care plan that address any assessed needs.

17. Refers patients and/or families to a wide-range of community services; including but not limited to provision of health care coverage, income maintenance programs, transportation services, etc. by completing agency specific referral forms

18. Follows acceptable infection control guidelines during room interview with particular attention to patients in isolation. Adheres to standards precautions with all patients.

19. Collaborate with care team, including but not limited to members of the medical and nursing staff, dietary, and physical therapy personnel to plan for patient discharge needs

20. Explores and collaborates with resources within the organization and community to meet defined patient needs.

21. Provides or arranges counseling to meet the psychosocial, emotional and spiritual needs of the patients/family members/caregivers in a manner consistent with their beliefs and desires and in accordance with the patient's plan of care.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting and grasping are necessary body movements utilized in performing duties throughout the work shift.

2. Must be able to exert up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently and/or negligible amount of force constantly to move objects.

3. Hearing within normal range is required.

4. Visual acuity within normal range is required.

5. Must be able to sit for extended periods reading charts, files, etc.

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Exposure to bodily fluids, human tissues, contagious diseases, sharps, and explosive gases.

2. Exposure to toxic gases, fumes, and odors.

3. Exposure to high stress and constant interruptions.

4. Exposure to electrical current.

5. Exposure to radiation from x-rays.

6. Exposure to bad road conditions.

7. Exposure to wind, rain, snow, sleet, mud, high and low temperatures, animals and insects, and hazardous roadways.

8. The majority of work is performed in the patient's home and may require extensive travel.

9. Subject to unpredictable situations. May be exposed to adverse or unpleasant home environments.

SKILLS AND ABILITIES:

1. Must have the ability to perform concentrated and complex mental activity with frequent involvement in complex and highly technical situations.

2. Must have the ability to work successfully under highly stressful conditions and must be capable of adapting to varying workloads and work assignments on a constant basis

3. Must have the ability to make sound, independent judgments based upon scientific and regulatory principles, and also be able to collaborate successfully with other multi-disciplinary team members in an appropriate fashion.

4. Ability to communicate effectively, both verbal and written.

5. Ability to communicate and to use tact and diplomacy in dealing with physicians, patients, families and other health care professionals.

6. Ability to work independently while being able to communicate with team.

7. Ability to assess complex situations and develop a realistic, appropriate and safe discharge plan.

8. Demonstrate characteristics of dependability and punctuality.

9. Must be able to handle and maintain confidential information.

10. Must have the ability to comprehend and perform oral and written instructions and procedures.

11. Must have math skills to work with statistics, data collection, etc.

12. Must be able to organize, prioritize and complete assigned tasks.

13. Must be able to work extended hours.

14. Demonstrates flexibility in response to unexpected changes in work volume, emergencies, staffing or scheduling changes.

Additional Job Description:

Scheduled Weekly Hours:
32

Shift:

Exempt/Non-Exempt:
United States of America (Exempt)

Company:
SHC WVUHS Home Care

Cost Center:
374 SHC Home Health Reedsville

Address:
12 Rousch Drive

Westover

West Virginia

WVU Medicine is proud to be an Equal Opportunity employer. We value diversity among our workforce and invite applications from all qualified applicants regardless of race, ethnicity, culture, gender, sexual orientation, sexual identity, gender identity and expression, socioeconomic status, language, national origin, religious affiliation, spiritual practice, age, mental and physical ability/disability or Veteran status.

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