Christiana Care is offering an exceptional case manager opportunity within the maternal-child areas of Christiana Hospital. We are seeking a highly motivated Social Work professional to utilize their behavioral health and case management expertise. This position works in a collaborative setting with other professionals to assess transition needs for maternal-child patients. In addition this position provides bereavement services to patients within this population. The Social Work professional will be responsible for crisis counseling, connecting patients with community resources, working collaboratively with State and community agencies, creating a safe and timely transition plan, utilization management, arranging a variety of post discharge services, and co-facilitation of the monthly bereavement support group This position is a full-time day shift position working M-F from 7:30 am to 4:00 pm. On the third Monday of the month, this position works 11:30 am to 8:00 pm in order to co-facilitate the monthly bereavement support group. The successful candidate may be eligible for a $10,000 sign on bonus to be paid over a period of 24 months. PRI M A R Y FU N C T I O N: To a ss i st pati e nts and fa m i l i e s to i d e nt i fy soci a l, emot i on a l, and e nvironme n tal n ee ds a n d to conn e c t t h e m wi t h a v a i l a ble re sour ce s/ s e rvi ce s throu g h the p r ovis i on of a f ull spe c trum of dis c h a r g e planning a nd so c ial wo r k s e rvi ce s.
PRI N CIP A L D U T I E S A N D R E S P O N S I B I L I T I ES : Works with the patient, family, and other members of the health care team to formulate a discharge plan that provides the patient services in the appropriate post-acute care setting. Gathers and assesses information regarding the patient's physical needs, mental status, family support system, financial resources, and available community and governmental resources. Employs assessment to develop a comprehensive case management plan that will address the patient s goals of care and identified needs for discharge planning. As part of the discharge plan development process, collaborates with other healthcare professionals in multi-disciplinary meetings and patient rounds. Receives updates and guidance regarding Utilization Management from appropriate UM staff to assist with length of stay coordination.
D e te r m i n e s spe c ific o bje c t i v e s, g o a ls, and m ea sur e s that a r e d e si g n e d to m ee t t he patients n ee ds th a t have b ee n identified th r ou g h a ssessment. The plan w i l l be ac t i o n -o r ient e d a nd t i me - spe c ific in c lud i ng c ol l a bor a t i on with ut i l iz a t i on man a g e ment to m a n a g e len g th of sta y . Maintains c onta c t wi t h the p a t i e nt s th i rd-party p a y o r s to e nsure the most c os t -e f fec t i ve plan of ca re is being ca r r ied out a nd a ppro p ri a te in n e twork pro v ide r s a r e b e ing ut i l iz e d.
P rovid e s info r mation about r e sour ce s and opt i ons a v a i l a ble in the c om m uni t y a nd c oordin a tes s e rvi c e d e l i v e r y . I nte r p re ts pati e nt / f a m i ly n ee ds a n d pr o vides info r mation con ce rni n g the a v a i l a bi l i t y a nd l i m i tations of re sour ce s. Edu ca tes a nd a ddr e sses c on ce rns w i t h se r vice d e l i v e ry including se r vice g a ps a n d acce ss i ssues. I mp l e ments disch a r g e plan th r ou g h se r vice re f e r ra l and c oordin a t i on ac t i vi t ies. The S o c ial W o r k e r a lw a y s assu r e s that the p a t i e nt i s g iven the c hoice regarding post-acute a g e n c ies a nd s e rvi ce s.
S c r e e ns hi g h - risk p a t i e nts and c onsults attending ph y sici a ns r e g a rding potential dis c h a r g e planning pro b lems identifi e d because of this pro ce ss. I nte r vie w s and a ssess e s r e f e r re d a nd hi g h - risk p a t i e nts t o d e te r m i ne the n ee d a nd d e sire f or soci a l wo r k se r vic e s.
P rovid e s f ac tual i n fo r mation bas e d on c u r r e nt knowled g e , to provide ps y c hoso c ial support a nd a ss i st t he p a t i e nt / f a m i ly in coping with t h e ir dise a se to i mprove their ov e r a ll h ea l t h ca re man a g e ment. Edu ca tes the patients and families re g a rding v a rious s y mp t oms and c onse q u e n ce s r e lat e d to spe c ific d ise a s e s, co n di t ions and hospi t a l iz a t i on. This i n f o r mation wi l l also in c lude sp ec ifics re g a rding methods of pro fe ss io n a l i nte r v e nt i on a nd d e s c ription of the pro c e ss of so c ial wo r k in t e rv e nt i on in a m e dic a l sett i n g .
I n acc o r d a n c e with esta b l i shed c l i nic a l g uidelines, stand a rds, a nd p a thw a y s, est a bl i shes a c ompr e h e nsive disch a r g e plan f or those p a t i e nts with po s t -ac ute ca re n ee ds. The S o c ial W o r k e r w i l l or g a ni z e , se c u re , in t e g r a te a nd mod i fy the re sour c e n ece ssa r y to m ee t t he g o a ls s tat e d in t he disch a r g e plan. T he Sr S o c ial W o r k e r w i l l mon i tor p a t i e nt c a re ac ross the c ont i nuum t h r ou g h follo w - up with patients, f a m il ies, a nd c om m uni t y se r vic e s.
R e p re s e nts pati e nt / f a m i ly by in t e rv e nin g , n e g ot i a t i ng, a nd p r omo t ing their c on ce rns. Probl e ms r e quiring a dvo cac y may include ind i vidual a nd c lass inequit i e s or inad e qu a te a nd non -e x is t e nt hospi t a l and/or c om m uni t y r e sour ce s, i.e., insur a n c e b e n e fits, housin g , e tc.
Maintains p e rtine n t and ti m e ly do c ument a t i on in patient ' s medic a l ch a rts a nd
d e p a rtme n tal r e c o r ds. A cc u ra tely maintains r e quir e d d e p a rtme n tal st a t i st i ca l dat a .
Col l ec ts and maintains sp ec ific in f o r mation r e quir e d for p e r f o r man c e i m p r ov e ment ind i ca tors a nd r e s ea r c h p r oje c ts. Uti l i z e s the d e p a rtme n t Qu a l i ty S e rvi c e P lan to a ddr e ss se r vice is s u e s as n ee d e d.
P e r f o r ms pati e nt / f a m i ly e v a luations a nd histori e s. P rovid e s ps y c hoso c ial support throu g h ind i vidual, g roup, or f a m i ly c ouns e l i n g , a s ne e ds di c tat e . Cont i nuously re vie w s se r vice a r e a f or g roup support n ee ds a n d oppo r tun i t i e s.
Maternal-Child specific responsibilities include:
- Providing bereavement services for this patient population.
- Working collaboratively with State and/or community agencies to create a safe and timely transition/discharge plan
- Co-facilitating a monthly bereavement support group
Re p re s e nts C h r is t ianaC a r e , wh e n r e qu e sted, throu g h p a rticip a t i on on c om m uni t y /s t a te bo a rds, c om m i t te e s, p a n e ls, cou r t he a rin g s, et c .
Attends re g ula r ly sch e duled sta f f m ee t i n g s, i.e., te a m, d i vis i on a l, or ce nte r wide .
S uppo r ts t he d e p a rtme n tal e du ca t i on a l and sta f f d e v e lop m e nt i ni t iatives in c lud i ng sup e rvision of und e r g r a du a te/ g r a du a te stud e nts en r ol l e d in an acc r e di t e d sc h ool of so c ial wo r k. As a f ield wo r k sup e rviso r , is r e spons i ble to F ield I nstru c tor/ L iaison f r om t he sch o ol of so c ial wo r k for e v a luating student s p e r f o r man c e a nd te ac h e s the b a sics of medi ca l social w o r k a nd a v a i l a ble c om m uni t y re sour ce s. Att e nds r e g ula r ly sch e duled d e p a rtme n tal in-s e rvice p re s e ntations re g a rding n e w re sour ce s and c l i nic a l t ec hniques.
D e monstr a tes ski l ls and kno w led g e n ece ssa r y to p r ovide ca re a ppro p ri a te to n e on a tal, p e diatri c , a doles ce nt, a dul t , a nd g e ri a tric pa t i e nts, i n c lud i ng knowl e d g e of g ro w th and d e v e lop m e nt, t he a bi l i t y to ob t a in and inte r p re t info r mation t o identify p a t i e nt ne e ds, a n d to provide the ca re n ee d e d.
P e r f o r ms a ss i g n e d wo r k sa fe l y , a dh e ring to established d e p a rtme n tal s a f e ty r ules a nd p rac t i ce s. R e ports to supe r visor, in a ti m e ly mann e r, a ny uns a fe ac t i vi t ies, c ondi t ions, h a z a rds, or sa fe ty vio l a t i ons th a t m a y ca use in j u r y to ones e lf, oth e r e mp l o y ee s, patients a nd visi t o r s.
P e r f o r ms o t h e r re lat e d dut i e s as re quir e d.
E D U C A T I O N A N D E XP E RI E N C E R EQ UI R E M E N T S :- Mast e r s degree in Social Work (MSW) or Master of Social Services degree (MSS) f r om an acc r e di t e d g r a du a te s c hool.
- L ic e nsed CSW or MSW as required by the state of Delaware no later than June 11, 2024.
- Acute Care Social Work experience preferred.
- Maternal-Child position requires experience working with neonates, children and families
S P E CI A L R EQ UI R E M E N T S : CCM required within 18 months of eligibility
Associated topics: addiction, behavioral health, case, casework, cell, field, social, social service, social worker, violence