Location: Wenatchee, WA
Facility: Central Washington Hospital
Department:
Schedule: Full Time
Shift: Day/Evening Shift
Hours:

Job Description

Position Summary:

Under the general supervision of the Care Management Director, acts as Social Worker Associate for hospital patients. Works in a team environment to collaborate, coordinate, and negotiate, to procure services and resources for acute care patients. The RN Case Manager will monitor the clinical care. Communication among team members occurs at least daily and more frequently for the complex patient or plan.

The Social Worker Associate may be assigned primarily to one of the Acute Care units excluding unit 1100. The Social Worker is flexible in assignment and hours so as to meet the needs of the department. The Social Worker Associate is on-site and shares a weekend and holiday rotation with other staff.

Essential Functions:

1. Performs responsibilities in alignment with organizational mission and values.

Provides services to specific patient populations including initial assessment and evaluation, care plan development, and risk assessment; provides appropriate interventions; coordinates referrals; and facilitates transfers/discharges to meet patient care needs.

Functions within scope of practice and keeps current with the legal aspects of social services.

Demonstrates standards of behaviors throughout all interactions and maintains the dignity of those with whom interacting.

Maintains business demeanor and personal attire to reflect Confluence Health values.

Participates in lean project work and seeks opportunity to improve processes to achieve standard work and quality care.

Respects organizational, regulatory and national/regional standards, policies and procedures.

Responds timely and courteously to referrals, inquiries and requests.

Assists team members without prompting.

Maintains professional registration for social work

Addresses interpersonal issues, stressful situations, and conflict professionally and timely.

Maintains a clean, neat, and safe environment.

Confers with assigned mentor when needed.

2. Assessment and Planning: As part of Care Management Team assesses patients within identified case load to develop a comprehensive plan that will address those needs.

Collaborates with the RN Case Manager and general nursing staff to identify patients with complex social or supportive needs, including, but not limited to psychiatric diagnosis or behaviors, substance abuse, homelessness, new diagnosis of cancer or other life altering disease, or protective service situations.

Collaborates with Case Manager RN, nursing staff, physician, other disciplines as indicated, to facilitate a plan of care related to discharge planning and psychosocial needs, defining an action plan and identifying each team members’ responsibilities in the plan.

Identifies patient/family/significant other’s ability to participate in the plan and establishes strategies to overcome barriers identified.

Accurately identifies high risk factors such as family dysfunction, impaired coping, financial concerns, regulatory factors that might limit effective participation in planning and decision-making.

Conducts necessary conferences as soon as possible, in collaboration with the RN Case Manager, when family presents barriers to discharge.

Performs psychosocial assessments that are consistently comprehensive and reflect early identification of complex problems or changes in condition that would necessitate revisions to the plan for psychosocial management or disposition.

Monitors effectiveness of the plan and makes changes as needed.

Anticipates conflict or volatile situations and works to diffuse these situations quickly and proactively.

3. Coordination and Implementation

Communicates with patient’s family and involved physician(s) and other interdisciplinary team members to optimize plan for discharge/disposition.

Assures seamless transitions for the patient/family across the continuum of care by establishing appropriate plans and assuring complete and accurate communication prior to discharge/transfer.

Demonstrates knowledge of available resources available and uses them effectively to support the patient during the episode of care and in discharge preparations.

Prioritizes patients effectively in order to achieve timely and appropriate patient interventions.

Provides short term counseling to help make decisions about specific problems or crisis intervention with sudden, unexpected patient or family problems.

Is knowledgeable about entitlement programs and assists patients as needed to facilitate plan.

4. Monitoring and Evaluation Analyzes outcomes, patterns, and trends.

Identifies trends in psychosocial or discharge planning management for populations of patients and works with nursing and physician to establish standardized options for psychosocial intervention.

Monitors and applies federal and state regulations effectively.

Participates in reporting to DSHS/appropriate agency identified abuse, neglect, exploitation per mandatory reporting laws.

Monitors and reports to Director administrative issues that may affect reimbursement or increased length of stay and adds information to the Avoidable Days or Saved Days log.

Reports/supports reporting to DSHS/appropriate agency identified abuse, neglect, exploitation per mandatory reporting laws.

Updates LOS tracking log regarding patient’s clinical and disposition status.

5. Communication Demonstrates effective communication, documentation and interpersonal skills.

Advocates for the patient for additional resources if gaps exist.

Fosters cordial, positive and professional interpersonal relationships with patients, family members, physicians, staff, community agencies, insurance companies and peers.

Demonstrates understanding of and compliance with the terms of the Confidentiality Agreement.

Completes Psychosocial/Initial Assessment on each patient.

Completes progress notes in patient’s EMR when interaction is finished.

Documents patient/family interactions accurately and completely.

Approaches physician during rounds to discuss plan, obtain input and address concerns about patient needs and care.

Completes documentation of discharge location and status such as discharge disposition, SNF status, or Home Health Tracking sheets.

Communicates patient hand-off to team members providing detailed patient information.

6. MSW Practice Development

Meets advanced placement criteria within Master Social Worker program and adheres to performance expectations, such as weekly supervision by LICSW.

Establishes learning goals with assigned MSW mentor and updates weekly/monthly.

Dialogues with LMSW colleagues regarding complex patients to validate judgment on care plan and interventions integrating feedback received.

Tracks knowledge and skill development using LMSW competency assessment instrument and proactively seeks learning experiences to develop competencies.

Participates with assigned LMSW mentor to review progress toward learning goals and plan next steps

Demonstrates independent learning through use of outside resources to augment hospital experience.

Shares new information with colleagues and engages in discussions regarding patient advocacy, social issues and new social policy

7. The OB/Pediatrics/Nursery – exhibits the following competencies:

Assists patients to develop birth plan and a referral to an adoption agency of choice.

Counsels patient in the event of fetal demise.

Coordinates adoption planning with non-state involved adoption.

Follows the CWH Policy for Relinquishment of Newborns.

Creates a Home Safety Plan as needed.

8. Functions as part of the ED Health care Team in determining a safe discharge plan for identified patients.

Understands and respects EMTALA.

Sets up safety nets for patient with community resources such as Home Health Services, Aging and Adult Care.

Confers with the patient’s primary care physician as needed re: behavioral health/substance abuse issues.

Develops or follows (EDIE) patient-specific care plan for patients inappropriately using the ED.

Refers ED team to written patient-specific plan when patient presents.

Demonstrate Standards of Behavior and adhere to the Code of Conduct in all aspects of job performance at all times.

Qualifications:

Required:

    • A bachelor’s degree and currently in the last year of a Master’s of Social Work accredited program.

    • Medical Terminology ability to pass exam with 80% accuracy

    • One year of supervised social work experience in a health care setting working directly with patients or residents.

    • Knowledge of community resources.

    • Registered as Agency Affiliated Counselor

    • Currently certified in BLS, and recertified biannually.

    • Master in Social Work degree completed within 1 year to retain position.

    • Licensure as LICSW or LASW within 4 years of achieving MSW.

    • Demonstrates effective interpersonal and communication skills.

    • Demonstrates flexibility via an ability to adapt to changing priorities and regulations.

    • Demonstrates tact, diplomacy, negotiation skills, and good customer relations.

    • Ability to apply creative problem solving skills.

    • Ability to prioritize assignments and effective time-management skills.

    • Basic knowledge of clinical and psychosocial aspects of patient care.

    • Ability to present a professional presence and appearance.

    • Must be detail oriented, flexible, and committed to patient advocacy.

    • Ability to work interdependently.

    • Demonstrates skills in planning, organizing, and managing multiple functions and complex processes.

    • Knowledge of Medical Terminology with ability to pass exam with score of 80% accuracy at time of interview

    • Excellent verbal and written communication skills required.

    • Basic computer skills related to Windows navigation, mouse usage, keyboarding, email communication and password management.

    • Knowledge of area resources and referrals.

Desired:

Certification within a specialty is preferred, such as gerontology.

Additional Information

Who We Are: Confluence Health is an integrated healthcare delivery system that includes two hospitals and more than 40 medical specialties, to provide comprehensive medical care in North Central Washington. With over 270 physicians and 150 advanced practice clinicians, Confluence Health is the major medical provider between Seattle and Spokane. Our goal is to deliver high-quality, safe, compassionate, and cost-effective care close to home. Staying on the leading edge of healthcare innovation is important, so we invest in technology--to provide better care for our patients and allow our providers to operate at the highest level. Our Mission: We are dedicated to improving our patients' health by providing safe, high-quality care in a compassionate and cost-effective manner. Our Vision: To become the highest value rural healthcare system in the nation that improves health, quality of life, and is a source of pride to those who work here.

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