Clinical Social Worker

4 days ago

Detroit, Michigan, United States SYNERGY ALLIANCE GROUP LLC Full time
Job Summary

We are seeking a skilled Clinical Social Worker to join our team at Synergy Alliance Group LLC. As a Clinical Social Worker, you will play a vital role in providing high-quality patient care and support to our patients and their families.

Key Responsibilities
  • Assist patients and families in coping with problems associated with severe and long-term illnesses
  • Conduct patient and family interviews, prepare psychosocial assessments, develop treatment plans, provide counseling and crisis intervention, and direct patients to designated community agencies and resources
  • Provide consultation to patient treatment team members and participate in developing new patient care programs
  • Required to provide individual, family, and/or group treatment as part of interdisciplinary treatment plan
  • Provides quality patient care considering age-specific, developmental, cultural, spiritual, diversity, and/or other special needs or circumstances through competent clinical practices
  • Functions as a member of the interdisciplinary care management team
  • Interviews patients and families to obtain psychosocial data
  • Evaluates and gathers data from the patient, family, outpatient supports, and other collateral sources regarding plan of treatment and available resources, and develops an appropriate intervention plan
  • Provides a variety of direct services and clinical interventions in order to provide continuity of care and to help patients and families resolve socio-emotional problems associated with adjustment to illness, resource needs, mental health problems, and a variety of life events and transitions
  • Coordinates care of identified high-risk patient population across continuum, specifically addressing psychosocial issues
  • In collaboration with patient, family, and primary care provider, develops plan to address and manage issues which influence healthcare utilization, including services for home, as well as facilitates hospital-to-hospital transfers, hospice, extended care facility, acute rehabilitation, and long-term care facility placement
  • Refers patients to designated community agencies or resources for financial assistance, counseling, mental health, and substance abuse follow-up, and other support services
  • Conducts continuity of care planning for assessing needs, support services for home, as well as facilitates hospital-to-hospital transfers, hospice, extended care facility, acute rehabilitation, and long-term care facility placement
  • Provides ongoing assessment of educational needs of patient/family in collaboration with interdisciplinary staff and develops appropriate interventions and programs in response and maintains good working relationships with community resources
  • Demonstrates ability to make appropriate and useful changes in the patient's treatment plan when problems persist and recognizes when discharge and/or transfer of care is in the best interest of the patient
  • Advocates, educates, and facilitates resolution of patient rights, ethical, and legal issues, such as advance directives, end-of-life decisions, guardianship, etc.
  • Systematically identifies and addresses barriers and fragmentation of care while proactively/collaboratively problem-solving to find solutions
  • Documents social work assessment data and progress notes for each patient, including nature of psychosocial concerns, patient and family supports and needs, and intervention plan, in accordance with department documentation standards
  • Provides consultation to other patient treatment team members regarding socio-emotional factors that affect patient's condition, treatment plan, and recovery
  • Regularly communicates with other departmental and community agency personnel to coordinate social work functions and other services, exchange patient information, and ensure continuity of care
  • Utilizes pertinent population data to identify trends, potential areas of targeted intervention
  • Uses metrics to establish measurable goals and monitor outcomes
  • Uses professional expertise to advance policies and practices that improve access to care, ensure timely follow-up care, and support the delivery of evidence-based clinical management
  • In conjunction with identified leadership, develops, implements, and monitors clinical quality improvement processes within a specific population and/or program
  • Regularly prepares and presents written reports that track, monitor, and measure outcomes of interventions to address patient/population needs and identify and remove barriers
  • Provides Social Worker leadership in related committees, task forces, and work groups with a focus on improved health outcomes for the populations served
  • Serves as a change-agent and resource to foster adoption of process/service/system improvement initiatives at various points of services
  • Serves as an advisory role for social policies in community development programs
  • Understands legal issues that affect treatment, including but not limited to: child custody, divorce laws, child/adult abuse, duty to warn, recipient rights policies and procedures, alternative treatment orders (ATO's), and the commitment of inpatient hospitalization
  • Maintains knowledge of current trends and developments in the field
  • Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of co-workers, and to report all preventable hazards and unsafe practices immediately to management
  • Reports all preventable hazards and unsafe practices, including near misses and actual errors, either to management or using the anonymous reporting system (PEERS)
  • Assists other Health Center department and staff develop and implement new patient care programs and modify existing programs to meet the needs of patients and families
  • Conducts educational and orientation programs for staff, students, and other Health System employees
  • Attends and participates in departmental, Health System, and community committees and meetings as necessary

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