Social Worker - Care Management

Social Workers serving in a variety of departments and clinics are responsible for responding to referrals from the interdisciplinary team. The social worker will complete psychosocial assessments, develop and implement a plan of care that addresses patients' needs that promotes continuity of care, and facilitates transitions to the next level of care. The social worker will provide education, consultation, and serve as a liaison to the healthcare team regarding the patient and families' emotional, psychological, social, financial and developmental aspects of care.

Minimum Required: Master of Social Work from an accredited School of Social Work - MSW. | •    Licensed by the State of Ohio Social Work Board (LSW, LISW, or LISW-S). For employees working in UCMC Psychiatric Services, NCI-APS (Nonviolent Crisis Intervention with Advanced Physical Skills) Certification must be obtained within 90 days of hire. | Minimum Required: 1 - 2 Years equivalent experience. Preferred: 3 - 5 Years equivalent experience

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.

As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.

UC Health is committed to providing an inclusive, equitable and diverse place of employment.

Engagement and Exploration:

Engage patients and/ or their families into a helping process. Assess the psychosocial and mental health needs of patients and families to:

• Identify barriers to treatment
• Enhance patient's health status.
• Increase patient/family satisfaction Improve utilization of resources
• Develop rapport with patient and family for ongoing support as needed
• Adheres to the tasks and responsibilities specific to the department, service or clinic.

Goal Development and Implementation:

Develop a comprehensive plan of intervention in collaboration with the patient/ family and healthcare team. Implement a plan of care and monitor patient's response:

• Provide individual/family counseling, and social work intervention, as it relates to complex crisis management, mental illness, adjustment to illness, material assistance, healthcare decision-making, sexual assault, domestic violence, partner violence, elder abuse, competency, and any other psychosocial barriers in order to maximize the health status of patients.
• Advocate, mediate and negotiate to formulate a cohesive plan for maintaining or enhancing patient's health status, improving social supports, and moving patients safely across the continuum of care.
• Provide family education.
• Provide education about Advance Care Planning and assist with completing Advance Directives paperwork. 
• Initiate referrals to community resources as indicated.
• Facilitate discharge process to home, nursing facility, rehabilitation facility, LTAC, group home, treatment or other facility.

Evaluation and Termination:

• Briefly summarize care plan with patient/family and respond to questions and concerns.
• Provide patient/ family with linkages to community resources and services.
• Participate in process improvements in evaluating patient outcomes.
• Identify barriers in service delivery systems.
• Assess for transportation needs and arrange as appropriate.
• Facilitate referrals to disease specific agencies, especially as it relates to employment, financial resources, support services, chemical dependency services.

Education and Consultation:

• Provide consultation and training to medical staff and other healthcare professionals on psychosocial issues regarding illness and barriers to maximizing improved health status.
• Collaborate with co-workers and management to ensure the on-going development of the Social Work Department. 

Competency:

• Participate in activities that support enhanced customer service and results in increased Press Ganey scores.
• Attend staff meetings and mandatory departmental in-service training sessions & continuing education in-services; maintain positive working relationships with and knowledge about community agencies and services.
• Maintain timely, clear and concise documentation; and write reports as needed.
• Respond to E-mail requests and provide information as requested.
• Participate in quality and safety initiatives.