Identifies patient and family psychosocial and environmental needs related to admission diagnosis treatment and discharge by providing the highest quality evidence based care to patients while promoting cost-effective utilization of hospital resources. Works collaboratively with other members of the interdisciplinary team in developing and implementing a comprehensive integrated discharge plan to effect positive patient and family outcomes. Makes appropriate referrals for community services; may provide emotional support and therapeutic interventions crisis intervention bereavement services and patient/family education. Assesses and intervenes in situations involving mandating reporting. Provides supervision to graduate social work student interns. Identifies patients who present to the ED with non-emergent needs; identifies and resolves barriers to accessing primary and preventive services instead of ED; educates patients regarding how and where to access health care services including the roles of the PCP Urgent Care and ED refer to Health Home Care Manager as needed; educated patients on transportation resources in the community.
Education:
Minimum: Licensed Master Social Work (LMSW) or Licensed Clinical Social Worker (LCSW) in NY State or eligible for NY State License.
Professional Certifications:
Minimum: Screen certification or experience or intent to pursue within six months.
Work Experience:
Minimum:
Two years of related experience in Health Care.
Counseling and discharge planning experience.
Preferred:
Experience in Acute Hospital setting and/or Nursing Home knowledge: prior navigator experience.
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