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Mass General Brigham relies on a wide range of professionals including doctors nurses business people tech experts researchers and systems analysts to advance our mission. As a not-for-profit we support patient care research teaching and community service striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
Job Summary
The Ariadne Labs Home Hospital team is launching a pilot randomized controlled trial to test the acceptability and feasibility of providing acute psychiatric care to patients in their homes. Presently home hospital programs exclude patients with an active psychiatric condition; this trial will test the feasibility and acceptability of Behavioral Health Home Hospital (BHH). The BHH care model will provide a minimum of twice-a-day in-person nursing to patients with remote rounding by the BHH Research Psychiatrist and BHH Research Psychologist. Additional clinical care team members will provide care either in person or remotely. Patients admitted and randomized home as part of the trial will need to have a caregiver present. Additional support will be able to be provided by home health aides and mental health specialists. Medication will be dispensed by the clinical care team 24/7 monitoring will be conducted and patients will be able to join in-patient therapy groups remotely. The BHH Research Social Worker/Case Manager will be a key member of the BHH clinical care team as they will provide consultation assessment treatment interventions and advocacy for patients and caregivers.Qualifications
What youll do/Key Responsibilities
The BHH Research Social Worker/Case Manager is a key member of the interdisciplinary team who provides and oversees the provision of psychosocial care for selected patients and families.
Conducts bio-psychosocial assessments provides intervention and treatment as indicated.
Identifies high risk psychosocial factors of patients/families that impact health status.
Assumes clinical evaluation intervention and planning for patients with complex psychosocial risk (homelessness protective services frail elderly disabled psychiatric and substance abuse etc.).
Provides clinical services to patients/families that address psychosocial environmental age-specific and cultural issues.
Collaborates with and provides social work consultation to other disciplines within the setting and community.
Participates on Departmental Hospital Satellite community task forces and committees.
The Research Clinical Social Worker reports directly to the assigned Social Work Manager.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Clinical Practice:
Provides assessment of patients to evaluate mental health/psychiatric history/emotional issues/coping style understanding of illness/adjustment/compliance barriers to care cultural issues abuse/neglect and domestic violence.
Provides psychosocial assessment of families to determine family relationships/systems as they relate to care of the patient. Identifies family decision makers and caregivers; family understanding of illness and trajectory of care. Identifies family coping style family resources and cultural issues.
Employs a range of clinical interventions such as individual group or family counseling. Provides caregiver/family counseling/support to promote family cohesiveness to provide care to patient and prepare families for end of life. Advocates on behalf of patients and families to gain access to services and resources. Refers patients to other providers as necessary.
Develops comprehensive bio-psychosocial assessments responsive to age appropriate and cultural needs and concerns. Employs a range of clinical interventions such as psychotherapy (individual couples families and group) psychosocial counseling crisis intervention care coordination complementary therapies information and referral and safety planning. Advocates on behalf of patients and families to gain access to services and resources.
Provides mandated assessments when abuse is suspected (child disabled adult elder) and safety assessment when domestic violence is reported. Files reports as indicated.
Identifies patients psychosocial financial legal psychiatric or substance use that effect patient care management and collaborates with the team to facilitate patient care process.
Works effectively as part of the interdisciplinary health care team communicating regularly with the team and other members on cases and as issues arise. Documents timely and relevant information.
Coordinates family/team meetings as needed and when appropriate. Provides psychosocial consultation on patient care planning and patient/family management and community resources. Implements psychosocial programs based on patient/family identified needs.
Facilitates the appropriate and efficient use of hospital and community resources.
Participates in formal and informal clinical case reviews.
Quality Utilization Management: High Risk Psychosocial
Intervenes with appropriate individuals/departments/agencies regarding delays in service that may have an impact on quality of patient care length of stay or inappropriate patient admissions.
Reviews patient information for assigned caseload determines anticipated length of stay and psychosocial barriers to plan of care transitions discharge plan.
Interacts with home care community agencies and facilitates to ensure safe and timely patient care transitions.
Negotiates with care coordination team follow up contact with patient/family community agency or facility to evaluate the effectiveness of the patient care transitions and identifies problems in service delivery.
Ensures coordination of the communication process with patient/family concerning the plan of care including coordination of family meetings and warm handoffs.
Ensures that patient/family are involved in all phases of the care process to the greatest extent possible.
Maintains current knowledge of and identifies needs in service delivery within social governmental protective services and legal agencies.
Ensures that the patient and family receive consistent information regarding all aspects of care.
Communicates and collaborates with the Social Work Manager/Team to ensure efficient and quality patient care and equitable caseloads.
Leadership Teaching and Education:
Assesses patient/family learning needs styles and readiness. Educates patients/families based on treatment plan identifies barriers to care diversity issues and learning styles.
Demonstrates expert social work clinical practice within the department and with interdisciplinary staff. Provides education and consultation to interdisciplinary health care providers social work staff and community on psychosocial issues for patients.
Ability to consult/teach. Ability to communicate effective orally and in writing. Excellent interpersonal skills including negotiation skills necessary to collaborate within a multi-disciplinary team.
Demonstrates active ongoing commitment to professional growth and development of self and creates an environment conducive to the professional growth of others.
Participates in Departmental and Hospital committees.
Organizational/Administrative Skills:
Takes responsibility for own administrative duties including timely and appropriate documentation in patient medical records timely and accurate daily reporting of activities and Hospitals scheduling systems and accurate reporting of time worked.
Provides clinical documentation including psychosocial assessment progress notes and billing compliance (if appropriate).
Participate in staff meetings competencies mandatory compliance training educational meetings and research study trainings.
Software is updated by maintaining the latest version of software applications as defined by the IS department.
Professional Conduct: Adheres to and fosters compliance with NASW Code of Ethics and Department and Hospital clinical quality compliance and safety standards policies and procedures.
Patient Population: Staff member must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served on his/her assigned areas.
Qualifications
Licensed Clinical Social Worker (LICSW/LCSW) in Massachusetts
Masters degree in Social Work
Strong communication and interpersonal skills to build trust with patients and healthcare teams
Ability to work both independently and collaboratively in a fast-paced environment
Certification in Basic Life Support for Healthcare Providers required.
Active Drivers License.
Experience
Minimum 2 years of clinical experience preferably in care coordination case management or inpatient psychiatry care.
Adheres to all I C.A.R.E. standards.
Must show evidence of the basic analytic thinking necessary to care for a group of patients.
Knowledge Skills and Abilities
Travel required within Brigham and Womens Faulkner Hospitals geographic area.
Ability to work with various computer software applications and technologies required.
Demonstrate observational skills and the ability to set priorities.
Demonstrate excellent technical interpersonal organizational oral and written communication skills required.
Ability to function under stress with good interpersonal and communication skills.
Ability to work independently be self-directed and adapt to unpredictable circumstances.
Knowledge of community agencies/resources. Ability to advocate/negotiate systems for/with patients.
Additional Job Details (if applicable)
Physical Requirements
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
EEO Statement:
At Mass General Brigham our competency framework defines what effective leadership looks like by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance make hiring decisions identify development needs mobilize employees across our system and establish a strong talent pipeline.
Part-Time