Social Worker - Coordination of Care

Summary

Responsible for coordinating placement, community agency referral, and social coping aspects for all patients in the assigned areas, inclusive of all age groups served. Serves as a direct provider, referral source, and resource to other staff in an effort to promote the delivery of high quality, fiscally responsible continuing care services. Provides psychosocial support and guidance to meet the needs of the patient.

Strives to enable the patient to achieve an optimal level of health in accordance with hospital policies and procedures.

Cape Fear Valley Medical Center

Fayetteville, North Carolina

Coordination of Care

Professional

Days (United States of America)

The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:

• Conducts face-to-face interviews with patients and family members to develop therapeutic relationships and obtain psychosocial and financial information necessary for the facilitation of appropriate discharge planning
• Performs proactive screenings and assessments of patients’ clinical, psychosocial, and discharge planning needs
• Provides information to patients and families about community resources and educates them, as needed, about steps needed in selecting and accessing community resources
• Counsels patients and families regarding issues related to adjustment to illness, difficulties in accessing community resources, financial difficulties, future long-term care planning, protection issues, advance directives, and other psychosocial problems
• Refers patients and family members to in-house and community resources for help with financial programs and other tangible resources
• Serves as a patient advocate during the course of the patient’s hospitalization with a goal of promoting a sense of the continuum of care and a climate of concern for individual patient/family welfare
• Ensures that all necessary paperwork is completed, sent, and/or is in order prior to discharge or consistent with accepted practice
• Ensures appropriate transportation is arranged for patient discharge
• Other duties as assigned

The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:

• Bachelor’s degree in social work required
• Professional Certification in Case Management or Social Work (CSW, CCM, or ACM) preferred

• 1 year experience in Social Services, Home Health, Hospice or Acute Care setting required
• Acute Care Case Management experience preferred

• Must be flexible with scheduled hours to meet the needs of the department, unit, patient and family
• Work is not standardized and requires a high degree of prioritization skills
• Excellent interpersonal communication and negotiation skills
• Ability to communicate effectively and work with people of all social, economic and cultural background
• Proven written, telephonic and electronic communication skills
• Assertive and persuasive in interactions with customers, peers, management and core staff served
• Strong organizational and time management skills
• Proficiency with various computer programs including Microsoft Office, Midas, Provider Link, Valley Link, eHIM, and SMS.
• Ability to demonstrate respect and team building
• Flexible, open-minded and adaptable to change
• Ability to work collaboratively with department staff, physicians and healthcare professionals at all levels to achieve established goals, improve quality of outcomes, maintain or exceed Joint Commission standards and State mandates as they apply to the department operations

• Light carrying and lifting may be required
• Walking may be required to access all areas of the Medical Center
• Ability to effectively communicate orally to patients, family members, personnel and physicians
• Visual acuity to proofread hand or typewritten materials
• Manual ability to use telephones and computer keyboard

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity