Job Summary:
Manages the care for a specific group of patients; facilitates the safe movement of patients throughout the continuum of care ensures optimal utilization of resources service delivery and compliance with external review agencies local state and federal requirements. Collaborates with patients/families and the healthcare team in the transition planning process. Provides psychosocial assessments education to patients/families to assist in coping with the patients hospitalization and post acute care needs. Performs other duties as assigned. |
Job Responsibilities:
Perform a comprehensive psychosocial assessment when triggered to identify the patients health goals and coordinate services with the RN Case Manager for an effective transition plan. Meets directly with patient/family on an ongoing basis as identified. | ||
Identify the need for patient/family regarding Social / Psychosocial issues that need to be addressed. | ||
Build on the discharge planning assessment in developing coordinating implementing and revising a care plan to ensure good transition management and continuity of care (LOS discharge delays) cost reduction and patient self-management (patient activation). | ||
Collaborates with the physician and all members of the multidisciplinary team to facilitate care and assist in meeting discharge goals. | ||
Completes assigned goals. |
Education
Bachelors in Social Work |
Training
BSW graduate of an accredited school of social work | 2 years clinical experience as a social worker in medical/clinical setting |
Special Skills
Excellent interpersonal communication and negotiation skills. Ability to identify and coordinate appropriate resources in the community. Ability to work with people of all social economic and cultural backgrounds. Computer skills. |
Licensure
BSW | CCM;ACM;BSW |
Baptist Memorial Hospitals provide compassionate, close-to-home care for patients in the Mid-South. Learn about our medical clinics and health care services.