Social Worker MSW

2 weeks ago

Edgewood, Kentucky, United States St. Elizabeth Healthcare Full time
Job Summary: As a Medical Social Worker at St. Elizabeth Healthcare, you will provide social work intervention and proactive discharge planning support to patients and their families. Your expertise will ensure timely interventions to support patient transition to the next level of care. You will work collaboratively with the interdisciplinary team to promote throughput activities and optimize high-risk patient outcomes.

Key Responsibilities:
  • Complete thorough chart reviews upon referral and throughout patient stays.
  • Attend Bed Huddles and Care Conferences daily to promote throughput activities.
  • Provide information to Care Coordinators and Charge Nurses related to pending and confirmed discharges.
  • Participate in ongoing communication with physicians and the interdisciplinary team to develop a collaborative relationship aimed at improving clinical treatment goals and timely discharge.
  • Proactively educate patients about advance directives, post-acute services, and community resources available at discharge.
  • Complete proactive initial and ongoing psychosocial assessments to identify complex post-acute needs.
  • Provide support to patients with issues related to adjustment to illness and assist in securing support post-hospitalization.
  • Identify hospital and community-based resources to meet patient/family needs and provide referrals and advocacy.
  • Maintain active interaction with patients/families throughout the treatment/discharge planning process.
  • Make appropriate referrals to internal and post-acute service providers to ensure continuity of care.
  • Provide expertise to the team in developing treatment and discharge planning strategies for frequently admitted patients.
  • Assist in the procurement of services and serve as an advocate on behalf of patients/families for scarce resources.
  • Maintain high team standards by addressing coordination problems within the functioning of the healthcare team.
  • Identify and escalate issues related to LOS/Throughput/Readmission management.
  • Provide education to patients, families, and hospital staff regarding post-acute services.
Requirements:
  • Graduate of an accredited master's school of social work.
  • Licensed as an SW to practice social work in the state where work is being performed.
  • Meets contact hour requirements for licensure, including all state required courses.
Specialized Knowledge:
  • Knowledge of psychosocial issues related to health-related problems and post-acute care needs.
  • Excellent communication skills and ability to coordinate care well with an interdisciplinary team.

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