Care Coordinator/Social Worker - Inpatient

About the role

The Care Coordinator/Social Worker at Beloit Health System is responsible for completing bio-psychosocial assessments and discharge planning evaluations for patients admitted to Beloit Memorial Hospital. This role involves working collaboratively with the interdisciplinary team to provide resource and referral information to ensure a smooth transition from the hospital.

Responsibilities

• Screening assessments, clinical reviews, assess readmissions, and develop patient-centered discharge plans to address potential discharge barriers.
• Reviews readmission risk with the interdisciplinary team.
• Ensures that initial evaluations and discharge planning assessments are completed according to department policy.
• Responds to Care Coordination/Case Management referrals within 48 hours of scheduled work days.
• Demonstrates management of crisis situations in an empathetic and professional manner.
• Participates in multidisciplinary rounds to ensure appropriate recommendations and referrals for discharge planning.
• Maintains documentation to reflect the most updated discharge plan.
• Demonstrates ability to serve as a hospital liaison with outside agencies by maintaining professional and positive interactions.
• Participates in Quality Improvement projects identified by the department.
• Participates in planning, development, and presentation of community/hospital programs related to social work services.
• Maintains an accurate and up-to-date database of resources and referral information.
• Shows initiative in applying current scope of practice knowledge.
• Attends in-service presentations and completes mandatory education, including but not limited to: infection control, patient safety, quality improvement, MSDS, and OSHA standards (PPE, Blood borne Pathogens, Hazard Communications, Emergency procedures, and Job Safety).
• Ensures compliance with Joint Commission and ensures all regulatory and accrediting agency requirements are met.
• Reports significant errors or unanticipated outcomes in patient care which result in harm.

Requirements

• Minimum of Bachelor's Degree in Social Work (Master's Degree preferred).
• Certification to practice as a social worker in the State of Wisconsin (minimum of temporary certification).
• Understanding of discharge planning and multidisciplinary patient care.
• Excellent verbal and written communication skills.
• Able to document appropriately in the Electronic Medical Record.
• Excellent organizational and problem-solving skills.

Qualifications

Reporting Relationship: Manager and Director of Care Coordination.

Behavior and Attitude

The mission of Beloit Health System requires the employee to perform in a manner which ensures health and wellness services are delivered with high quality, value, and satisfaction to the patients and communities we serve.