Job Overview: Assess the psychosocial needs of the patient and family to develop, communicate, and implement an effective and comprehensive plan for psychosocial interventions and complex discharges, included but not limited to readmission in the high risk population. Is a resource regarding social systems, institutions, and behavioral and relationship patterns. Can skillfully apply the appropriate interventions to meet the needs of the patient and family. Collaborates with the multidisciplinary team to assure effective, efficient, appropriate care in order to optimize the health status and assure a smooth transition between levels of care for patients served. Job Requirements: Bachelor's or Master's Degree in Social Science or Social Work Licensed Social Worker Payer rules for reimbursement Community resources for patients who have limited funds Excellent assessment and intervention skills Computer literate Up to 1 year experience Clinical Healthcare Community Social Work Job Responsibilities: Responds to referrals and assesses the psychosocial and complex discharge needs of patients and families using data from the medical record, patient, multidisciplinary team, family, and other available resources. Develops and implements plan of care based on assessment including counseling or crisis intervention, and facilitates linkages to community resources and services. Revises plan based on patient and family response. Communicates (verbally and written) and collaborates with the multidisciplinary team to advise of the plan and patient response to the plan. Applies root cause analysis to readmissions and works with the health care team, patient, and family to resolve the issues. Provides on-call services according to departmental policy including timely response and appropriate follow up. Other Job-Related Information: Working Conditions: Climbing - Occasionally Hearing: Conversation - Consistently Hearing: Other Sounds - Consistently Kneeling - Occasionally Lifting 50+ Lbs - Rarely Lifting <50 Lbs - Occasionally Pulling - Occasionally Pushing - Occasionally Reaching - Frequently Sitting - Frequently Standing - Frequently Stooping - Occasionally Talking - Consistently Use of Hands - Consistently Color Vision - Occasionally Visual Acuity: Far - Consistently Visual Acuity: Near - Consistently Walking - Consistently TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS... * Welcome everyone by making eye contact, greeting with a smile, and saying "hello" * Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist * Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS... * Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met * Offer patients and guests priority when waiting (lines, elevators) * Work on improving quality, safety, and service Respect: ALWAYS... * Respect cultural and spiritual differences and honor individual preferences. * Respect everyone's opinion and contribution, regardless of title/role. * Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS... * Value the time of others by striving to be on time, prepared and actively participating. * Pick up trash, ensuring the physical environment is clean and safe. * Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS... * Acknowledge wins and frequently thank team members and others for contributions. * Show courtesy and compassion with customers, team members and the community |