Complex Care Team Clinical Social Worker Lead (LICSW)

About the role

The Complex Care Team Clinical Social Worker is an integral member of the Complex Care Management Team. They are a vital collaborator on the care team to help reduce length of stay and readmission due to psychosocial factors. In conjunction with the unit-based teams, they support and interface with the interdisciplinary healthcare teams.

Responsibilities

• Rapidly performs clinical biopsychosocial assessments to include evaluation of social history, current functioning, mental health, substance use, psychiatric history, support system, coping styles, understanding of illness, barriers to care, cultural issues, abuse/neglect/safety concerns, intimate partner violence.
• Provides psychosocial assessment of families to determine family relationships/systems as they relate to care of the patient.
• Identifies family decision makers and caregivers, family understanding of illness and trajectory of care and coping styles, family resources and cultural considerations.
• Formulates diagnostic impressions, recommendations, and plan.
• Collaborates with care team to develop and optimize plan of care and disposition to reduce length of stay and readmission.
• Works in a very fast-paced, dynamic, demanding environment, receiving consults throughout the day to evaluate a broad range of issues and concerns acutely.
• Manages consultation requests by understanding and prioritizing needs relative to patient acuity and barriers to safe discharge.
• Employs a range of clinical interventions such as psychotherapy (individual, couples, families, and group), short-term counseling, crisis intervention, safety planning, care coordination, complementary therapies, information and referral.
• Advocates on behalf of patients and families to gain access to services and resources.
• Works effectively as a vital collaborator with the interdisciplinary care team. Provides psychosocial consultation on patient/family care and management. Facilitates the appropriate and efficient use of Hospital resources.
• Collaborates with many internal collaterals to include but not limited to: Office of Patient Relations, Office of General Counsel, Optimum Care, Child Protection Team, HAVEN, Police and Security, International Office, Office of Decedent Affairs and external collateral contacts and agencies to optimize the plan of care for patients and families.
• Identifies patients’ psychosocial, financial, legal, psychiatric or substance use discharge barriers that affect patient care progression and collaborates with the team to facilitate safe transitions in care.
• Coordinates family team meeting as needed and when appropriate in collaboration with the interdisciplinary team.
• Facilitates the appropriate and efficient use of hospital and community resources.

Qualifications

• Master's Degree in Social Work required.
• Licensed Independent Clinical Social Worker (LICSW - State License).
• 5-7 years of clinical social work experience required.