Overview

Supports and complies with quality activities and performance standards. Uses a family systems theory framework to gather information, to include, patient's social, psychological, cultural, environmental and financial situation.; Identifies legal, financial, social, educational and environmental factors which may affect medical care and/or discharge plans.; Informs care team members of critical information that will affect patient's stay while in the hospital and/or discharge.; Assesses and assures appropriate reporting of any potential/actual abusive relationships, such as child/adult abuse and/or neglect and domestic violence.; Assesses upon request any psychiatric/substance abuse disorders and initiates or assists in arranging appropriate interventions and referrals for treatment upon discharge.; Assessments are completed within one business day of referral.; Monitors clinical and financial indicators (i.e. length of stay, readmission rates, etc.) and takes action to achieve continuous improvement.; Incorporates differential diagnostic approaches including DSM V as needed or within scope of practice.; Practices under the NASW Code of Ethics.; Participates in continuing education, workshops, didactics, and conferences.; Uses evidence based practice to provide social work interventions. Expedites the discharge plan through excellent networking and team skills.; Provides patient advocacy and ensures patient's Freedom of Choice and Medicare's Important Message.; Provides timely follow up with all multidisciplinary team members in order to complete the discharge plan.; Attends multidisciplinary rounds to ensure timely communication with team. Receives referrals for appropriate placement from Care Coordinator and reviews patient information from electronic record.; Interviews patient and/or family regarding facilities and secures signature on Freedom of Choice form and Medicare Important Message.; Completes Medicaid's assessment tool.; Updates Resource Management Center with any changes in insurance/demographic information, patient's level of care.; Updates Care Coordinator of patient's post-acute discharge plan.; Ensures that appropriate discharge documentation is available to accompany patient to facility.; Attends Unit Rounds and huddles to keep multidisciplinary team informed of patient status.; Communicates with physicians regarding Discharge Plan.; Stays in communication with patient and family regarding post-acute plans.; Coordinates appropriate transportation.

Certification in Case Management (CCM, ACM RN-C) required within one year of eligibility. BLS required within 90 days of hire.

Education

Masters Degree Required

Certification/Licensure

None Required

Experience

1 year of patient care required.

Benefits: Sentara offers an attractive array of full-time benefits to include Medical, Dental, Vision, Paid Time Off, Sick, Tuition Reimbursement, a 401k/403B, 401a, Performance Plus Bonus, Career Advancement Opportunities, Work Perks, and more. 

Our success is supported by a family-friendly culture that encourages community involvement and creates unlimited opportunities for development and growth. 

Be a part of an excellent healthcare organization that cares about our People, Quality, Patient Safety, Service, and Integrity. Join a team that has a mission to improve health every day and a vision to be the healthcare choice of the communities that we serve!

Keywords: Talroo-Allied Health, Monster, MSW, Medical Social Worker