Behavioral Health Care Coordinator, Social Services, Per Diem, Monday Friday, Varied days, Hybrid

Hours: Per Diem Monday - Friday Varied days Hybrid

$40.00 - $52.78

Position Summary:

ESSENTIAL FUNCTIONS

Job Responsibilities: Medical Social Worker

Care Transitions & Coordination

• Reports directly to the Director of Social Service and Indirectly reports to Unit Manager and Practice Leader. Works collaboratively with unit team and responds timely efficiently and respectfully.

• Keeps department director abreast of any issues trends identified and/or needs weekly and/or more frequently if needed.

• Demonstrates professionalism and teamwork. Covers for co-workers during planned and un-planned absences and as requested by director.

• Communication: builds rapport and responds to needs of physician healthcare team members 3rd party payers referral sources and vendors to enhance internal and external customer service satisfaction

• Completes the Assessment fully clearly concisely and within 48 working hours of being assigned the case following

  documentation standards noted by department policies and procedures as well as state and federal regulations.

• Completes clear and concise documentation noting patient and family participation multidisciplinary involvement and other planning information as required by the department as well as state and federal regulation agencies.

• Conducts High Risk Screening including but not limited to the Health-Related Social Needs of new admissions for potential needs.
• Communication: builds rapport and responds to needs of physician healthcare team members 3rd party payers referral sources and vendors to enhance internal and external customer service satisfaction.
• Assists with discharge planning process assuring services/ placement is appropriate in the continuum of care with PASARR OBRA Level of Care form completion etc and are completed timely and efficiently as per regulatory standards.
• Conducts post discharge follow up on High Risk patients in an attempt to reduce re-hospitalization.
• The Discharge Planning Process: Completes discharge planning assessments timely efficiently and completely following regulatory standards and departmental policies assuring appropriate patient levels patient for home discharge with or without services or to another type of facility such as a SNF Acute Rehab etc. Develops coordinates and implements discharge plan on cases assigned with patient and/or family/so caregiver. Identifying patient preference and selection choice for HHA/SNF placements having patient preference form checked off and signed/dates by patient and/or plan is in place notify provider establish and determine anticipated readiness for discharge keeping patient/family/so informed and documenting such in the EMR. Closes case out using appropriate forms for transition of care communication timely and efficiently. Collaborates with the team to assist the Multidisciplinary Team in providing discharge planning activities to assist in expediting a patients discharge as part of the care transitions process. It is the expectation that the Social Worker remains current and proficient in the discharge planning process.
• Multidisciplinary Team Rounds: participates in discharge planning rounds daily. Works collaboratively with multidisciplinary team to determine each patients needs concurrently including post-acute care when needed; addresses LOS issues addresses potential needs resources referrals for other disciplines and a positive professional manner. Works closely with members of the multidisciplinary team including physicians patients families hospital staff and community agencies.

• Utilization Management: Utilization Review. Providing clinical information to payers monitoring length of stay seeking care authorizations for concurrent reviews and for prior authorizations as they pertain to discharge planning activities and case management. Demonstrating timely and efficient service. Attend and participate in LLOS meetings twice a week.

• Quality & Statistical Data: Participates in performance improvement activities and other projects as assigned by director. Completes a statistical record of each case closed noting recorded hours contacts made and services provided so that department documentation and statistics can be completed. It is the expectation that Statistical Sheets are accurate and complete upon submission.

Job Responsibilities: LICSW Behavioral Health Care Coordinator

• Informs patients of their rights provides information and education to patient and family regarding the care plans as part of their specific care needs when indicated (i.e. discharge planning URCO and appeal process guardianship court commitments admission/hospitalization status Power of Attorney and Conservatorship; Advanced Directives/Healthcare Proxy Interpreter Services. Section 12 and 35 process etc)

• Provides information and education to patients and their families regarding the care plan as part of their specific care needs and works closely with members of the multidisciplinary team including physicians patients families hospital staff and community agencies.

• In addition to the Medical Social Work discharge planning duties the following will be conducted specific to the responsibilities of an LICSW for Behavioral Health non- emergency consultation and documented accordingly. More commonly known as BH Care Coordinator role. This position is considered a Hybrid model .

• LICSW Psychosocial Assessment: Upon a Providers Order the LICSW completes a Behavioral Health Psychosocial Assessment within 48 working hours. Assessments completed fully clearly and concisely per standards.

• LICSW Therapy Sessions are completed upon each visit recording intent of session and duration of time for each session noted . Identification of type of therapy provided such as Individual Family and or group therapy as patient awaits discharge reducing or eliminating idle non-therapeutic time within the medical unit integrating Primary and Behavioral Healthcare. LICSW provides therapeutic intervention as needed to assist alleviation of stressors and/or trauma that may be associated with acute psychological-behavioral health needs. Assisting patients to help them manage behaviors while patient is waiting for discharge documenting interventions timely and efficiently.

• Emergency Service Provider Crisis Evaluation on Inpatient Med/Surg Unit will be responsible for the BH Crisis Evaluation. With that completed the LICSW will provide ongoing therapy to the patient remaining on the medical unit until a BH discharge can be secured or until another appropriate discharge in a lesser setting is secured providing brief interventions and support medical behavioral health and psychosocial interventions as part of the care team and keeping them informed of progress.

• For those patients being discharged from the medical unit and not involved with ESP; the LICSW will provide information and referral service to patient and help secure ongoing therapy services post discharge and document such service within the EMR.
• Provides LICSW Supervision and Peer Review duties.

JOB REQUIREMENTS

Education:

• Masters degree in Social Work or related field required.

Licenses:

• State licensure required as LICSW.

Skills:

• Current working knowledge of insurance providers and community resources available such as inpatient and outpatient providers is a plus and essential in care transitions including but not limited to discharge planning and post discharge follow up as needed.

• Demonstrated ability to clearly assess and treat behavioral health needs as well as other psychosocial aspects of patient care including but not limited to the health-related social needs of our patients; good knowledge of assessment counseling/therapy and crisis intervention techniques.

• Ability to work independently and with a team.

• Excellent verbal and written communication skills required.

• Computer experience for data collection report writing and quality monitoring.

• Ability to work with community agencies to mobilize resources required.

• Demonstrates flexibility and adaptability to change.

Work Experience:

• One to three years experience: inpatient and/or outpatient settings such as behavioral health inpatient outpatient PHP IOP addiction treatment inpatient IOP community service provider private practice inpatient medical hospital outpatient clinic skilled nursing facility home care services.