Quick overview
Job description
The Social Worker provides home care services to patients and their families maximizing utilization of personal family community and health care resources.
Assesses the capacity of the home caregiver to cope with the patient's needs in care plan development
Assesses the patient's third party payer coverage to develop transitional plans
Conducts ongoing interdisciplinary assessment and development of individualized care plan in partnership with patient, representative and caregiver(s)
Provides patient, caregiver and family counseling
Providing patient and caregiver education
Communicates with the physician and other healthcare practitioners as related to current home health care plan
Participates in the HHA's quality assessment and performance improvement program and HHA sponsored in-service training
Demonstrates a good working knowledge of transitional facilities, community resources and agencies available
Demonstrates empathy and strong negotiation skills with patients and families when assessing transitional level of care needs
Uses necessary knowledge and skills appropriate to the developmental level, spiritual and cultural needs of the patient served
Directs discharge planning
Assists the attending physician/interdisciplinary team in evaluating the psychosocial needs of the patient demonstrating a clear understanding of diagnosis prognosis care needs and outcome goals
Identifies participants/patients requiring crisis intervention and acts to resolve the issue(s)
Maintains current knowledge of state and federal changes impacting participant/patient population
Maintains knowledge of current regulatory and accreditation and third party payer guidelines
Monitors integrity of documentation for accuracy
Participates and supports ongoing quality improvement activities
Participates in the care planning process for patients served
Provides quality care to participants/patients within framework of Medicare, private insurance, self-pay and Medicaid guidelines
Required Education: Masters Degree in Social Work
Preferred Education:
Required Experience: Minimum of two (2) years in case work or counseling in a health care setting or social delivery system. Qualifications/skill needed to handle the responsibilities of the position. Demonstrated knowledge of community resources with focus on geriatric population. Proficient in Microsoft Office computer applications, internet access
Preferred Experience: One (1) year of experience in home health. One (1) year behavioral health background
Required Certifications and Licensures: Valid Virginia Driver's License
Preferred Certifications and Licensures:
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