Inpatient Social Work, Care Transitions
Company: Lahey Hospital and Medical Center
Location: Burlington
Posted on: May 7, 2024
Job Description:
When you join the growing BILH team, you're not just taking a
job, you're making a difference in people's lives.Job
Type:RegularScheduled Hours:40Work Shift:Evening (United States of
America)Lahey Hospital and Medical Center is now offering up to a
$3,500 signing bonus for our Inpatient Social Work, Care
Transitions position. Important Details: Signing Bonuses are paid
out in two payments. You will receive your first payment (half of
the total amount) of upon completion of the first 30 days of hire
and your second payment (half of the total amount) upon completion
of 6 months of hire. The bonus payments will be paid on the next
regular pay day following the date on which you become eligible for
the bonus. All payments are subject to applicable taxes.Job
Description:Assessment and Planning:As a member of the
interdisciplinary care team, identifies high-risk psychosocial
factors of patients/families that impact status and discharge
planning.
- Educates the care team on the impact of social drivers of
health (SDOH) on medical treatment and care planning.
- Develops a psychosocial assessment, and intervention plan
regarding identified patient and family needs utilizing all
available sources of information.
- Participates in inter-disciplinary and inter-agency
collaborative efforts to identify and coordinate care, treatment
and post-acute care needs.
- Psychosocial assessment includes social, economic, cultural,
age-related, and behavioral factors.
- Demonstrates competency in knowledge of community resources to
address identified needs.
- Provides crisis intervention and counseling services to assist
patients and families with their emotional needs and adjustment to
the medical episode.
- Documents assessments, intervention plans, and outcomes that
are consistent with departmental guidelines and Hospital
policies.
- Provides accurate, timely, and appropriate documentation of all
social work assessments and interventions in the electronic medical
record per regulatory policies and procedures (this says the same
thing as the bullet above. - We can eliminate the bullet
above.)
- Assesses and screens patients for interpersonal violence
(child, adult, elder). - Provides education and facilitates
reporting by interdisciplinary team members per hospital
policies.
- -Provides education and facilitates reporting by
interdisciplinary team members with direct knowledge of patient
condition and events of concern.
- Screen and identify SDOH risk factors that contribute to
readmission, such as inability to access medications, lack of
transportation, insurance status, etc.Care Coordination/Care
TransitionsAs a member of the Care Transitions, the inpatient
social worker collaborates with care providers and third-party
payors to ensure that all appropriate services and resources are
utilized in a timely and efficient manner.
- Actively participates in multidisciplinary rounds (MDRs) and
care conferences on assigned units and assists with documenting all
pertinent information in the medical record.
- Establish her/himself as an integral part of the team and
present each day in the units to which they are assigned.
- Maintains timely communications with third-party payor
representatives to identify discharge needs and available
resources.
- Seeks out members of the treating team to identify the most
efficient/effective plan to progress care and offers to assist with
the identification of resources to facilitate the plan of
care.
- Provides patient/support system education and resources
regarding options for care and completes relevant referrals to
health agencies, mental health facilities, counseling services,
social agencies, post-acute care providers, and disease or
condition-specific resources in an effective and timely manner
based on the patient condition/needs to minimize delays in patient
receipt of services.
- Demonstrates expertise in facilitating end-of-life discussions
and issues, including goals of care, hospice, and palliative
care.
- Demonstrates expertise in addressing advance directives, power
of attorney, health care representative, and guardianship issues
and serves as a resource to the interdisciplinary health care team
consulting with Legal as needed.
- Maintains working knowledge of in-house and community resources
and awareness of legal/risk issues related to care planning.
- Identify and utilize appropriate interventions to address
barriers to care/discharge; locate resources; identify options and
available supports; facilitate referrals and applications to
government/community agencies; advocate for access to resources;
coordinate referrals and/or placement plans; assist patient and
family to emotionally prepare for transitions; prevent readmissions
for non-medical reasons. Particular attention to high-risk, complex
care patients.
- May facilitate support and psycho-educational groups.
- Facilitates communication with the patient/family. - This
covers both the clinical aspect of communication and the
coordination of meetings.DocumentationDocument evaluations and
ongoing work in a timely and comprehensive fashion that meet
departmental standards.
- Utilize appropriate documentation templates for assessments,
brief interventions and progress notes in EHR.
- Initiate evaluation within 24-48 hours or one business day of
the referral or consistent with departmental standards to respond
the same day when possible.
- Complete all appropriate forms within established time
frames.
- Complete departmental statistics within established
timeframes.
- Ensure care coordination needs of assigned patients are met,
and there is adequate documentation in the patient's medical
record.
- Ethics/Standards
- Maintain patient confidentiality and complies with professional
ethics according to professional (NASW) and department
standards.Qualifications:RequiredMaster of Social Work degree from
an accredited school of social workState of Massachusetts licensure
as an LCSWPreferredTwo years of healthcare social work/case
management experienceCCM or ACM (Commission for Case Management or
American Case Management Association)NASW membershipLahey Hospital
and Medical Center is now offering up to a $3,500 -signing bonus
for our Inpatient Social Work, Care Transitions position. Important
Details: Signing Bonuses are paid out in two payments. You will
receive your first payment (half of the total amount) of upon
completion of the first 30 days of hire and your second payment
(half of the total amount) upon completion of 6 months of hire. The
bonus payments will be paid on the next regular pay day following
the date on which you become eligible for the bonus. All payments
are subject to applicable taxes.To be eligible:
- Current and former BILH candidates - restrictions apply.
Employees within the BILH system are not eligible for the bonus or
if you have been employed by a BILH entity within the last
12-months. Employee must be in good standing to receive the bonus
at the time of payment.
- --- Signing Bonus is determined on a full-time status of 40
hours. Hours less than 40 hours will be prorated. Per Diem roles
are not eligible.
- If you leave Lahey Hospital & Medical Center before your first
anniversary you will pay back the signing bonus.
- --- Please note, signing bonuses are subject to change based on
the organizations hiring needs and will be determined by Talent
Acquisition on an ongoing basis. BILH/LHMC Talent Acquisition
reserves the right to change signing bonus eligible jobs and
amounts at any time.FLSA Status:ExemptAs a health care
organization, we have a responsibility to do everything in our
power to care for and protect our patients, our colleagues and our
communities. Beth Israel Lahey Health requires that all staff be
vaccinated against influenza (flu) and COVID-19 as a condition of
employment. about this requirement.More than 35,000 people working
together. Nurses, doctors, technicians, therapists, researchers,
teachers and more, making a difference in patients' lives. Your
skill and compassion can make us even stronger.Equal Opportunity
Employer/Veterans/Disabled
Keywords: Lahey Hospital and Medical Center, Haverhill , Inpatient Social Work, Care Transitions, Healthcare , Burlington, Massachusetts
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