Under the general direction of the Health Center Medical Director, the incumbent in this position is responsible for utilizing sound clinical judgment and expertise to coordinate care management activities to help resolve/provides guidance to individuals and or/family on a variety of medical/psychosocial concerns for the patients of Heritage Health Center.
KEY JOB DUTIES AND RESPONSIBILITIES
Interviews patients to complete assessments on their psychological status, level of care needs, insurance benefits and other patient resources.
Assist patients/family through individual or group conferences to understand medical recommendations, and to assist them in making informed decisions about their medical care.
Mobilizes patient/family to utilize their own strengths to make adjustments to support and implement a life changes.
Serves as the patient advocate to ensure their needs are recognized and met determine nature and degree of problem, disability or illness and interprets data for other members of the health care team.
Works in close collaboration and communication with all the members of the health center care team in order to ensure seamless coordination of services within and between teams.
Assists family members in understanding the patients' needs and aids patients and family in working out realistic functional goals for patients.
Networks with and acts as a liaison to community agencies to maximize utilization and benefits the patient.
Have a superior knowledge of and utilizes community resources to assist patients to restore patient to optimum social/health adjustments within their individual capacity.
Assist the health care team in identifying system barriers, which negatively impact quality of patient care.
Provides social services coverage at the school-based health center to support the work of the health care team at this site, and meet with parents and school officials as appropriate to promote the biopsychosical well-being of the students.
Assists students and parents with problems concerning relationships or other aspects of social functioning.
Helps students and family members through individual or group conferences to understand, accept, and follow medical recommendations.
Develops and writes informational material for educational purposes; conducts workshops and educational sessions for the health/school based health centers.
Provides referrals for psychiatric care to assist patients with a behavioral health/emotionally conditions, and collaborates with psychiatric team in diagnosis and treatment plan.
Assists and plans discharge of difficult patients from the practice.
Routinely meets with patients who are receiving prescribed narcotics to review the "contract", secure the signatures, and identify an appropriate setting for referral to address their addiction disorder.
Assists in training university students on field placement as a phase of their professional social work curriculum and conducts in-service training for health center staff.
Coordinates referral and evaluation of client to interdisciplinary diagnostic teams; serves as case manager for referred client.
Participate in agency-wide meetings as assigned.
Experience with electronic health record systems.
Provides direction to medical students, interns, or residents assigned for training.
Excellent written and verbal communication skills are required.
This position does not supervise others.
REQUIRED KNOWLEDGE, SKILLS, AND COMPETENCIES
Excellent written, verbal communications and interpersonal skills.
Good time management and organizational skills.
Ability to make quality, independent decisions.
Strong analytical and problem solving skills. Ability to work in a face-paced, high volume ambulatory care environment, and be able to meet expected deadlines.
Knowledge of the principles, practices, techniques and professional standards in the field of social work, excellent Knowledge of community organizations and social service programs, ability to maintain the strictest levels of confidentiality
Master's degree in Social Work, two to four years' experience working in a social service field or related capacity; OR, Any equivalent combination of experience and/or education from which comparable knowledge.
Two years of supervised experience of mid-level social services/case management personnel.
Active New York State License to practice Social Work.
The incumbent must be willing to conduct home visits to residents in the community and or in a congregate setting. The incumbent will be required to travel independently using public transportation. Evenings and weekends maybe required.