Work Shift

Day/Evening

Scheduled Weekly Hours

16

Summary

This position supports Mercy's philosophy of patient centered care by providing our patients and their families support and resources to manage the many psychosocial aspects of illness. A social worker works with patients and their identified support system to access the needed resources to cope with illness and life changes triggered by illness. This may include referral to needed community resources, assistance in applying for financial assistance programs or the provision of supportive counseling in coping with illness and the life changes resulting from illness.

Job Description

Job Duties/Essential Functions

• Job Duties
  • Ensure that all accurate and clinically relevant information is communicated with patients, their families and co-workers at hand offs and other times as needed. Take all measures necessary to ensure that the appropriate and involved parties have communicated necessary information in order to allow for the best possible patient outcome.
  • Assesses patient/family social, emotional and economic factors through initial admission assessment and ongoing evaluation/assessment and reassessment.
  • Serves as a resource to the patient/family assisting them with accessing appropriate resources to address concerns/needs and removing barriers to care.
  • Actively participates in multidisciplinary team meetings advocating for the patient and educating team regarding psychosocial issues impacting ability to cope with health care concerns and safely preparing for care transitions/discharge planning.
  • Documents in the medical record accurately, timely and in accordance with professional and department-specific standards.
  • Demonstrates an understanding and an ability to work effectively with the community professionals/agencies providing patient services throughout the continuum of care.
  • Maintains current knowledge of community and other resource networks for planning/provision to meet patients' needs.
  • Demonstrates skills in advocacy for all populations served.
  • Provides counseling and ongoing therapeutic relationship to assist patients/families in coping with the effect of serious illness, death and grief and/or mental illness
  • Provides education and consultation to health care staff on patient behaviors, communication, conflict resolution, confidentiality and professional boundaries
• Follows Mercy's safety guidelines, carries out job-specific safety duties and responsibilities, and promptly reports any unsafe conditions, situations, incidents and injuries.

Department Specific Duties

Behavioral Health Unit

• Assists in re-certification and utilization review process for Medicaid Behavioral Services for patients placed on medical floors.
• Demonstrates an ability to de-escalate patient situation utilizing CPI techniques. (ED; Behavioral)
• Assists in transfer, change in level of care and discharge planning by implementing and coordinating services required for discharge throughout the hospital.
• Works with inter-disciplinary team (Doctors, Nurses, Access, and Social Workers) to facilitate discharge planning.
• Assists with psychiatric bed placement.
• Completes substance abuse use/chemical dependency consults in ED and throughout the hospital.
• Provides back-up coverage to Behavioral Unit Social Worker, as needed.

Care Coordination

• Assists in transfer, change in level of care and discharge planning by implementing and coordinating services required for discharge.
• Demonstrates an ability to de-escalate patient situation utilizing CPI techniques.
• Assists with bereavement support and outreach activities, such as Caregivers Center, etc.
• Assists with determining patient's appropriateness for hospice services consistent with Hospice of Mercy policies and admission criteria and in conjunction with patient's physician. (Hospice)
• Provides information regarding Hospice's program of care and services to patients, physicians and other sources of referrals. (Hospice)
• Uses group work as appropriate mode of intervention with assigned caseload. (Dialysis; Behavioral)
• Assists patients/families with psychosocial concerns related to health care condition.
• Educates patients and family members on their rights and responsibilities, disaster preparedness, travel and transplant and other subjects as identified. (Dialysis; Home Care)
• Manages the transplant referral and coordination program, including educating patients and families on transplant and mentoring them through the process. (Dialysis)
• Provides chemical dependency assessments on both the medical and behavioral units as assigned. (Behavioral)
• Provides education regarding chemical dependency and mental illness to patients and their identified support system.
• Provides brief counseling to patients with substance abuse disorders utilizing motivational interviewing model.

Hospice Community

• Assist in transfer, change in level of care and discharge planning by implementing and coordinating services required for discharge. (Hospice; Home Care)
• Demonstrates an ability to de-escalate patient situation utilizing CPI techniques.
• Assist with Bereavement Support Groups and outreach activities. (Hospice)
• Assists with determining patient's appropriateness for hospice services consistent with Hospice of Mercy policies and admission criteria and in conjunction with patient's physician. (Hospice)
• Provides information regarding Hospice's program of care and services to patients, physicians and other sources of referrals. (Hospice)
• Uses group work as appropriate mode of intervention with assigned caseload. (Dialysis; Behavioral)
• Makes scheduled home visits in accordance with department specific guidelines to assist patients/families with psychosocial concerns related to health care condition. (Home Care; Hospice)
• Educates patients and family members on their rights and responsibilities, disaster preparedness, travel and transplant and other subjects as identified. (Dialysis)
• Manages the transplant referral and coordination program, including educating patients and families on transplant and mentoring them through the process. (Dialysis)
• Provided substance abuse assessments on both the medical and behavioral units as assigned. (Behavioral)

Medical Cancer

• Implements the Distress Tool for all patients receiving Chemotherapy and Radiation.
• Meets with patients to review the Distress Tool and determine appropriate referrals to address needs.
• Available for support groups or educational programs within cancer center
• Assists with financial services such as gas cards, transportation, meals and any other needs.

Mercy Center for Memory Health

Mercy Family Counseling

• Demonstrates an ability to de-escalate patient situation utilizing CPI techniques.
• Assist with support groups and outreach activities.
• Assists with determining patient's appropriateness for clinic through initial assessments of patients to determine mental health needs and coordinate establishing care.
• Manages referral/ scheduling queue.
• Provides access to a single point of contact for patient, families and providers.
• Assists facility staff to connect to services through references and referrals when applicable.
• Medication prior authorizations for MPG and MFC.
• Backfill all providers schedules on a daily basis.
• Support staff coverage and miscellaneous tasks as needed.

Mercy Home Care