Per Diem - Social Work Care Manager- Star Community Health

St. Luke’s University Health Network•Bethlehem, PA

25d

About The Position

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Care Manager Social Worker SCH is responsible for providing social work care management services to patients and their families. The CM SW SCH provides professionally established methods of assessing a patient's unique bio-psychosocial status, assists patients and families in resolving problem areas, and connects them with appropriate community resources and services. Responsible for the psychosocial component of patient care as it relates to medical stability and wellness, the CM SW SCH collaborates with both health care and community partners to address social determinants of health and promote self-management of care needs. The CM SW SCH also collaborates with the Outpatient Care Manager RN, Care Management Outreach Coordinator and multidisciplinary teams as needed to address the social needs of the patient.

Requirements

Master's degree in social work from an educational institution accredited by the National Council on Social Work Education (NCSWE) required.
State licensure for MSW in NJ required (if position routinely supports NJ residents)

Nice To Haves

Bilingual preferred.
State licensure for MSW in PA preferred.

Responsibilities

Provides assessment, care planning and intervention to patients and families, including psychosocial and resource evaluation and planning, advocacy, as well as crisis intervention as appropriate.
Provides counseling directed towards helping patients and families cope with and understand the relationship between physical functioning, illness and the consequent social/emotional impact and adjustments required.
Consults with providers, nurses and other members of the health care team to facilitate interdisciplinary care and address effective continuum of care coordination.
Investigates insurance benefits as well as community resources to provide and facilitate appropriate referrals based on patient/caregiver agreement.
Organizes individual patient care meetings with internal and as necessary, external multidisciplinary team members and the patient/caregiver to evaluate progress and to identify and resolve problems that may interfere with a positive patient outcome.
Provides patient/caregiver and/or care team education as needed as it relates to government mandates/laws.
Collaborates proactively with patient/caregiver, care team members, and community partners as necessary to address bio-psychosocial needs to ensure efficient and effective continuity of care, utilization of resources and to avoid unnecessary hospitalizations.
Ensures appropriate clinical and patient care documentation in patient charts, completes reports and other requested/required patient documentation as needed, and maintain required statistical documentation for the department's management information system.
Functions autonomously under the Organization and Departmental policies and procedures and regarding the NASW Code of Ethics.
Acts as a liaison to community agencies, health institutions, etc., to address systems issues affecting patient outcomes by serving, as able, in community groups and organizations.
Demonstrate competency in the assessment, range of treatment, knowledge of growth and development and communication appropriate to the age of the patient treated.
Other related duties as assigned.