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Presbyterian is seeking a skilled and compassionate Social Worker for Hospice and Palliative Care. The Hospice/Palliative Care Social Worker is responsible for the development planning implementation and evaluation of psychosocial interventions for patients in our Home and Transition Services programs. This position will identify patients with complex psychosocial needs assist with eligibility determination for social programs and funding sources and connect patients with community assistance from various special funds and agencies. As the mental health professional of the team the Hospice/Palliative Care Social Worker aims to improve quality of care and life while reducing complications and readmissions.
Type of Opportunity: Per Required Need .001 FTE)
Work Schedule: Days
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On the basis of referral consultation or case finding assesses patients and family s psychosocial risk factors through evaluation of prior functioning levels appropriateness and adequacy of support systems reaction to illness and ability to cope.
May provide initial screening in the ED for crisis intervention and overcapacity situations.
Intervenes with patients and families regarding emotional social and financial consequences of illness and/or disability; accesses and mobilizes family/community resources to meet identified needs: Provides appropriate crisis management to patients and families.
Provides support and counseling to patients / families experiencing and/or anticipating issues to adjusting to illness catastrophic diagnosis changes in living situations and bereavement.
Provides intervention in cases involving child abuse/neglect domestic violence elderly abuse institutional abuse and sexual .
Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the health care system.
Participates and arranges discharge planning activities for patients to ensure a timely discharge and to provide appropriate linkage with postacute providers.
Works with families exhibiting complex family dynamics that impact directly on patient care and discharge.
Works collaborates with the case manager and multidisciplinary team members regarding discharge planning and arranges for the appropriate level of care needed as determined by patients continuing clinical care needs.
Educates patient/family and physician regarding postacute options and addresses issues of choice.
Actively participates and provides pertinent information in complex rounds discharge planning huddles unit daily whiteboard rounds.
Functions as the lead in assisting patients and families to obtain available financial and other resources including but not limited to Medicaid SSDI County Indigent Funds UNM Cares etc.
Provides intervention in child abuse/neglect domestic violence guardianship (temporary/ permanent) foster care adoption mental health placement advance directives adult/elderly abuse child protection and sexual .
Assists as indicated with endoflife matters
Meets CMS Condition of Participation Requirements and applicable state and federal regulations.
Serves as a lead in obtaining legal guardianship and competency determinations. Completes and disseminates all necessary legal in clinical documentation as required.
Provides and updates community services resources advice and referral information.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education skills competency supports departmentbased goals which contribute to the success of the organization.
Serves as preceptor mentor and resource to less experienced staff.
Results of assessments interventions and discharge planning are documented in the medical record according to departmental policies and procedures.
Other duties as assigned.
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About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients members and the communities we serve. We are a locally owned notforprofit healthcare system comprised of nine hospitals a statewide health plan and a growing multispecialty medical group. Founded in New Mexico in 1908 we are the states largest private employer with nearly 13000 employees including more than 1200 providers and nearly 3500 nurses.
Our health plan serves more than 640000 members statewide and offers Medicare Advantage Medicaid (Centennial Care) and Commercial health plans.
AA/EOE/VET/DISABLED. PHS is a drugfree and tobaccofree employer with smoke free campuses.
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