Social Worker - Full Time - Days

Why work for Nebraska Methodist Health System?
At Nebraska Methodist Health System, we focus on providing exceptional care to the communities we serve and people we employ. We call it The Meaning of Care – a culture that has and will continue to set us apart. It’s helping families grow by making each delivery special, conveying a difficult diagnosis with a compassionate touch, going above and beyond for a patient’s needs, or giving a high five when a patient beats a disease or conquers a personal health challenge. We offer competitive pay, excellent benefits and a great work environment where all employees are valued! Most importantly, our employees are part of a team that makes a real difference in the communities we live and work in.

Job Summary:

Responsibilities:

Essential Functions

Psychosocial management - Complete psycho-social evaluation of the patient and family system. Properly identifies patient's likelihood of needing post hospital services and availability of those services ensuring a smooth and safe transition at discharge.

• Assists in the development of the discharge plan with patient/family and interdisciplinary team.
• Provides complete functional, psychosocial assessment within 24 working hours of referral, order or identification of a patient.
• Performs an ongoing assessment of the patient, support system, and environment to determine factors that impact the patient's ability to maintain the highest level of independence.
• Ensures services provided are consistent with the patient's identified needs.
• Facilitates discharge planning by documenting an accurate picture of patient's discharge needs, services offered and any barriers to discharge or plan of care from being implemented or carried out.

Continuity/Transition Management – transitioning of the patient to the appropriate level of care needed. Provides assistance with discharge planning – identifies appropriate agencies/facilities for patients requiring assistance at home or placement at another level of care.

• Maintains a level of expertise and current knowledge base on available community resources and services available.
• Informs patient/family of services available and initiate services that are consistent with patient's identified needs to maintain the highest level of independence.
• Documents and informs patient/family of their freedom to choose providers of post hospital care and respect preferences.
• Documents and discusses the results of evaluation with patient/family. Seeks input from other healthcare facilities and professionals who may provide care before admission.
• Initiates services that are consistent with the patient's identified needs by providing referral to appropriate resources as soon as recognized.
• Provides and documents a list of agencies available that serve the geographical area requested by the patient. (HHA, SNFs).
• Discloses to patient/family if the hospital has any financial interest with post hospital agencies. Effectively communicates with agencies/facilities of the patient needs.
• Provides referral to appropriate community resources as soon as recognized to need identified patient's discharge and financial needs.
• Provides appropriate information through Ensocare to agencies/facilities.

Keeps patient/family informed of anticipated discharge4 and changes in discharge plan. Participate in the development of a discharge plan and assesses the effectiveness.

• Collaborates with physician, interdisciplinary team and patient/family to develop comprehensive, proactive discharge plans for all complex patients.
• Participates in daily huddles and unit rounds and effectively communicates any barriers to discharge with patient/family, physician and interdisciplinary team.
• Collaborates with interdisciplinary team to ensure barriers are addressed and ensure a safe discharge occurs.

Initiates appropriate interventions to ensure the patient/family of a safe discharge.

• Identification of financial needs that impact the patient's ability to meet their financial responsibility and initiates appropriate referral.
• Identify and assist patient in obtaining necessary durable medical equipment to ensure a safe discharge.
• Completes PASSR for nursing home admissions.
• Performs mini mental exams as requested to assist appropriate safe discharge. Ensure that proper committal procedure performed.
• Assist physician and patients/families in advance directive and end of life discussions and assure that proper documentation obtained. Initiate appropriate referral to assist with completing advance directives, guardianship, disability assistance etc.
• Provides immediate counseling of patients and family and effectively diffuses crisis and refers to appropriate services for abuse/neglect as needed to include APS, CPS.
• Assist physicians, patients and families with adoption process.
• Assist physicians, patients and families with coordination of dialysis needs.

Advocacy & Education – ensuring the patient has an advocate for needed services and any needed education. Promotes the education of all members of the interdisciplinary team, physicians/office staff, and patient/families.

• Provides patient/family education and counseling about existing health problems and related care.
• Promotes the education of all members of the interdisciplinary team, physicians and office staff, community providers and patient/families to Social Worker responsibilities.
• Acting as resource to staff for counsel, education and referral for access to the most appropriate care.
• Provides ongoing education based on needs assessment – including use and understanding of community resources, issues related to funding and areas of patient choices and accountability.
• Communicates issues/trends (positive/negative) to Director/Supervisor. Participates in new employee orientation.
• Willingly performs other duties as assigned.

Participates in the development and implementation of community collaboration based on evidence-based practice that includes core values, readmission efforts, decreasing length of stay efforts, and improving communication with the community.

• Assures that the core values, readmission, LOS, communication efforts are a community process and that the guidelines are well researched.
• Knowledgeable of community care efforts to decrease readmissions, appropriate ED utilization and admissions.
• Makes appropriate referrals to community providers through Tav Connect.
• Coordinates community meetings to meet the needs of the community effort that benefit the patient and/or family through the episode of illness from pre-hospital to post-hospital care.
• Utilizes Tav Connect to document community resources and barriers of high-risk patients. Participates in Readmission and Chemo Huddles to ensure appropriate utilization of resources, appropriate setting for care and opportunities to decrease readmissions.
• Provides concerns or barriers with community partners so communication will occur as soon as problems or concerns are identified.

Schedule:

Work Schedule: M-F, Days, 7-Week rotating weekend schedule

Job Description:

Job Requirements

Education

• Bachelor's Degree in Social Work or Human Services related area required.
• Master’s degree preferred.

Experience

• Minimum 1-2 years relevant discharge planning or counseling experience required.

License/Certifications

• Certified Social Worker (CSW) preferred.

Skills/Knowledge/Abilities

• Knowledge of the discharge planning process, community resources and the networking process necessary to provide high-quality service to patients and their family, hospital staff and others seeking services.
• Knowledge of counseling techniques to the degree necessary to provide appropriate emotional support to patients, their families, hospital staff and the public, and the process of an interdisciplinary team approach to patient care.
• Excellent communication skills, verbal and written.
• Demonstrates ability to maintain favorable relationships with physicians and health system personnel.
• Is self-directed and able to multi-task and prioritize work assignments.
• Able to deal with resistance and complex situations.
• Functions as an educator to physicians and health system personnel.
• Must be objective and logical.
• Demonstrates critical thinking skills.
• Ability to foster an attitude of teamwork and trust.
• Requires skills in obtaining empathetic listening, psycho-social assessment, problem solving and crisis intervention techniques, and facilitate an interactive team process in working with patients.
• Requires the ability to compile information into an accurate objective social history, communicate effectively, and assess the need for follow-up of certain patient/family/employee situations.
• Requires the ability to assess patient/family needs to provide for quality service delivery.

Physical Requirements

Weight Demands

• Light Work - Exerting up to 20 pounds of force.

Physical Activity

• Not necessary for the position (0%):
  • Climbing
  • Carrying
  • Kneeling
• Occasionally Performed (1%-33%):
  • Balancing
  • Carrying
  • Crouching
  • Distinguish colors
  • Grasping
  • Lifting
  • Pulling/Pushing
  • Standing
  • Stooping/bending
  • Twisting
  • Walking
• Frequently Performed (34%-66%):
  • Fingering/Touching
  • Keyboarding/typing
  • Reaching
  • Repetitive Motions
  • Sitting
  • Speaking/talking
• Constantly Performed (67%-100%):
  • Hearing
  • Seeing/Visual

Job Hazards

• Not Related:
  • Chemical agents (Toxic, Corrosive, Flammable, Latex)
  • Physical hazards (noise, temperature, lighting, wet floors, outdoors, sharps) (more than ordinary office environment)
  • Equipment/Machinery/Tools
  • Explosives (pressurized gas)
  • Electrical Shock/Static
  • Radiation Alpha, Beta and Gamma (particles such as X-ray, Cat Scan, Gamma Knife, etc)
  • Radiation Non-Ionizing (Ultraviolet, visible light, infrared and microwaves that causes injuries to tissue or thermal or photochemical means)
  • Mechanical moving parts/vibrations
• Rare (1-33%): - Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) (BBF)

About Methodist:

Nebraska Methodist Health System is made up of four hospitals in Nebraska and southwest Iowa, more than 30 clinic locations, a nursing and allied health college, and a medical supply distributorship and central laundry facility. From the day Methodist Hospital was chartered in 1891, service to our communities has been a top priority. Financial assistance, health education, outreach to our diverse communities and populations, and other community benefit activities have always been central to our mission.

Nebraska Methodist Health System is an Affirmative Action/Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation, gender identity, or any other classification protected by Federal, state or local law.