Description
In collaboration with a multi-disciplinary care team, this position is responsible for the timely coordination of health care services to meet the patient's individual need and promote quality and cost effective outcomes.
Serves as a resource to the team to assist patients and care givers with psychosocial needs for 90 days post-discharge in the community setting, provide health coaching and collaborates with allied health partners across the continuum of care.
Conducts social work care management activities by phone or in-person with patients and caregivers, including visits to patients in the home setting.
Creates and updates a database of home and community-based psychosocial resources for assigned caseload and for use by the multidisciplinary team.
QUALIFICATIONS :
Master's degree in social work (MSW), counseling or nursing.
Knowledge of APS mandatory reporting laws.
Two years' experience in the provision of social services and or discharge planning in the post acute care setting preferred.
Knowledge of basic medical terminology.
Advanced communication skills in advocacy, negotiation, confrontation and conflict resolution.
Proficiency with Microsoft Office and electronic medical records
License / Certification / Registration Requirements
None
Salary Range :
$48.79 - $63.59 USD Hourly
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