MSW-Social Worker, House Calls Program
Requisition ID: NSL0001R9|
Corporate Services -- Westbury
Performs psychosocial assessments and case management services for advanced-age, homebound patients with complex medical issues. Collaborates with clinical healthcare team to develop and implement individualized treatment plans for patients.
1. Performs psychosocial assessments and case management services.
Interviews and evaluates patients and families and reviews available, related information.
Evaluates patient/family understanding of patient’s condition and treatment as it relates to family dynamics and patient’s progress.
Provides program introduction and orientation to patients and families.
Formulates and implements a care management plan that addresses patients identified needs, issues, resources and care goals.
2. Provides counseling to facilitate patient adjustment to various conditions.
Counsels patients and families to enhance coping with illness, treatment, and discharge planning.
Provides crisis intervention for high risk patients, as needed.
Engages patients and families to establish care goals. Provides guidance in advanced directives, end of life preferences, medical orders for life-sustaining treatment, etc.
Provides anticipatory grief and bereavement counseling, as needed.
• Evaluates effectiveness of psychosocial treatment on an ongoing basis and modifies plan, as needed.
3. Provides transitional care services to patients being discharged
Visits patients in hospital and/or skilled nursing facility.
Works with hospital and/or facility care teams to expedite patient’s safe and timely discharge.
Visits patients post-discharge in the home setting to foster transition into homecare services.
4. Collaborates with healthcare team involved in patient’s care to enhance care plan and integration of services. Contributes to the understanding of the social and emotional elements of patient’s life related to their diagnoses and treatment.
5. Develops and expands knowledge of available community resources and demonstrates ability to facilitate referrals.
6. Documents patient/family contacts, psychosocial assessments and treatment in electronic medical record.
7. May participate in related research and quality initiatives, and staff development programs.
8. Performs related duties as required.
- Master’s Degree in Social Work, required. Licensed Clinical Social Work (LCSW), preferred.
- Current, valid New York State Driver’s license, required.
- Case Manager Certification (CCM), preferred.
- Prior clinical social work experience, required. Experience in geriatrics, homecare, palliative care or hospice, preferred.
- Ability to communicate effectively with patients and families, while being sensitive to cultural diversity.
Transforming care, optimizing patient satisfaction and creating better patient outcomes are just some of the things our talented team members are doing at North Shore-LIJ each and every day. As a culture committed to providing our customers with the highest quality service, we stand behind our core values: Patients first; Caring; Excellence; Innovation; Integrity and Teamwork. It is our commitment and our culture that sets us apart from others and is the cornerstone of everything we do. Join an organization whose team members are valued, cared for and offered continuous opportunities to grow. Click on the link to learn more about us: www.northshorelij.com/goals
Please note: North Shore-LIJ is a smoke-free environment. Smoking and the use of tobacco products is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises. Free smoking cessation programs and quit medications are offered to team members who wish to quit through the North Shore-LIJ Center for Tobacco Control.
Job: Social Workers
Primary Location: Corporate Services -- Westbury
Organization: NSLIJHS - Homecare Corporate
Schedule: Full Time
Shift: Day Job