Primary responsibility is to apply clinical knowledge and experience to the identification of patients with psychosocial and / or discharge planning needs in order to ease the patient's transition into the next level of care or return to the home. Conducts a comprehensive psychosocial assessment to identify social and practical environmental problems which are interfering with the patient's health and well being. Provides social work intervention to assure that services and counseling are provided as indicated by the assessment. Insures that the after care needs of the patient are met.
The ideal candidate must be thoroughly versed in family assessment of ecological and etiological assessment; must be highly trained to deliver caring, professional counseling services to patients and families. Must be skilled in developing support systems for patients using family, community agencies, and treatment resources. Must be skilled in emergency room evaluations and triage procedures. Adheres to code of ethics of National Association of Social Workers.
Demonstrates and maintains knowledge and skills necessary to care for the patient group of, Adults and Geriatric.
Conducts and documents assessments, including High Risk Screens, of the patient within the guidelines and time frame indicated in departmental policy.
Demonstrates knowledge and awareness of the psychosocial needs of patients and families such as adjustment to illness, disease impact, loss and bereavement, health care decision making, education, problem solving and planning.
Develops a plan and utilizes appropriate interventions to assist the patient/family address the identified psychosocial needs. Continues ongoing assessment according to patient needs/status and per policy.
Coordinates discharge planning and other services with the Case Manager and other members of the health care team to assure appropriate and continuous care is provided to the patient upon discharge from acute care.
Based upon an assessment of the patient/family system, assures appropriate referrals and resources are obtained and coordinated to provide continuous care, maximize functional capacity and preserve the patient's independence.
Verbalizes knowledge and demonstrates consistent use and compliance with written protocols.
Demonstrates a working knowledge of intensity of service and severity of illness, admission, discharge criteria. Identifies delays in service/processes that impact length of stay, avoidable days, and other level of service issues.
Financial Assistance. Maintains knowledge base regarding available Financial Assistance Programs. Provides information and referral to patients and families to assist with making application to appropriate programs.
Completes and follow up with applications for MC and Medicaid.
Keep on call log of patients seen and time of each episode.
Qualifications Minimum Qualifications:
Completion of Masters Degree in Social Work from an accredited university
Licensure as a Licensed Clinical Social Worker (LCSW) in the State of Missouri
About SSM Health St. Mary's Hospital – Jefferson City
SSM Health St. Mary's Hospital - Jefferson City is a 167-bed, full-service community hospital located in Missouri's state capital. The hospital moved to a new, state-of-the-art building in November 2014. The hospital features a dedicated inpatient pediatric unit, a Wound Center and Outpatient Treatment Center. Other services offered at the hospital include emergency services, cardiology, orthopedic care, cancer care, outpatient surgical services, maternity care and women's health.
You’ve known us as many names throughout St. Louis, and now, we’re bringing our hospitals, doctors, home care and other services together under one name – SSM Health. With seven hospitals, 350+ physicians, more than 40 physician locations and 12,000 employees, we are part of something bigger and better. We’re connected to a wealth of resources, expertise and advance technology to help you, your fa...mily and our community live long, healthy lives.
We’ve grown and changed a lot over our 143-year history. Our name may be changing but our mission remains the same