Social Worker

NEIGHBORHOOD FAMILY PRACTICE; Cleveland (OH); Sur place; USD 52 000 - 74 000; Plein temps

Résumé du poste

Neighborhood-Family-Practice seeks an experienced Social Worker to help patients and families access community resources, coordinate care, and address social determinants of health. You will collaborate with medical and behavioral health teams to improve patient well-being and reduce costs.

Responsibilities include care coordination, referral tracking, advocacy, documentation, and developing plans with patients and families. Evening/weekend flexibility and local travel may be required.

Qualifications

• Bachelor’s or Master’s Degree in Social Work required.
• Current, active LSW license to practice in Ohio.
• 3+ years’ experience in clinical, social service, or community resource setting; crisis intervention preferred.

Responsabilités

• Assess patient’s unmet needs and provide social work care coordination and linkage to services to improve health and reduce costs.
• Track referrals and assist in reducing barriers to services.
• Advocate for patients to access identified services.
• Maintain regular contact with patients, providers, and programs involved in care.
• Collaborate with patient, family, and providers to develop and monitor a plan of care.
• Document and report on patient services per organizational requirements.
• Ensure adherence to care plans and evaluate progress; support behavior change where needed.

Connaissances

Communication skills

Cultural sensitivity

Bilingual (preferred)

Care coordination

Formation

Bachelor’s or Master’s Degree in Social Work

Current LSW license (Ohio)

BLS certification

Outils

EPIC EMR/EHR

Microsoft Office

Database management

Description du poste

Position Overview: Describes the overall purpose of the position or why the position existsThe Social Worker assists patients and their families in navigating and gaining access to community resources, including services for mental health crisis, substance use, psychiatric, social, financial, educational, and other services appropriate for the patient’s need. The Social Worker supports patients through an integrated approach to care management, addresses social determinants of health (SDOH), and influences behavior changes resulting in improved well-being for the patient.Essential Duties and Responsibilities: The following description is a general representation of the essential duties and responsibilities of the position.Assess patient’s unmet needs and provide social work specific care coordination and linkage to appropriate services to enhance patient health and well-being, increase patient satisfaction, and reduce health care costs. Partner with other care coordination, clinical, and support staff to identify and meet patient needs.Track referrals for patient compliance and assist in reducing any barriers patients may face in receiving needed services. Advocate for patients as needed to gain access to identified services.Maintain regular contact with patients, service providers, and programs involved with patient care to proactively identify and resolve issues and barriers.Support with identifying, developing, and maintaining new and existing community partnerships, informal support systems, and community building opportunities to help patients access additional support systems. Provide consultation to Medical, Behavioral Health, and other team members as needed.Provide complete documentation and reporting on patient services, in accordance with organizational requirements.Collaborate with the Patient, family/caregiver(s), and Providers to develop plan of care and health goals. Monitor adherence to care plans, evaluate effectiveness, monitor patient progress, and facilitate change through solutions focused interventions and Motivational Interviewing techniques as needed.Remain knowledgeable of patient’s health insurance status. Connect patient to additional resources when needed.Respond to behavioral health crisis presentations that occur over the phone and in clinic as directed.Ensure compliance and quality of Social Work Services through adherence to applicable policies and procedures.Other duties as assigned.The requirements listed below are representative of the knowledge, skills, abilities, experience, and education an individual must possess to be able to perform the essential duties and responsibilities successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential duties and responsibilities.Education, Licensure, Experience:Bachelor’s or Master’s Degree in Social Work required.Current, Active, and Unrestricted Social Work license to practice in the State of Ohio. (LSW)Current and unexpired BLS certification.3+ years’ experience in clinical, social service, or community resource setting. Crisis intervention and/or case management experience is strongly preferred.Knowledge and Skills:Computer proficiency in Microsoft Office Suite, EPIC EMR/EHR, database management.Strong written and oral communication skills, including the use of electronic communication devices. Able to communicate effectively and with appropriate level of cultural sensitivity.Ability to manage a patient population with diverse needs and acuity.Ability to speak a relevant second language is preferred.Essential Physical Demands and Working Environment:Office work environment, but able to be flexible with changing patient and work environment needs.Evening or occasional weekend work.Ability to walk, sit, and/or stand for extended periods of time. Occasional lifting of up to 25 pounds.Willingness to travel locally or between sites. Active Driver’s License and Insurance strongly preferred.The physical demands and work environment described above represent those that an employee must meet to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.