Medical Social Worker, Senior Care, PACE

About the role

The Social Worker provides biopsychosocial assessment, crisis intervention, short-term counseling, advocacy, and resource linkage for patients and families across all ages and care settings, including psycho-education, support group facilitation, interdisciplinary consultation, discharge planning, staff education, and committee participation.

Responsibilities

• Provides biopsychosocial assessment
• Conducts crisis intervention
• Delivers short-term counseling
• Offers advocacy and linkage to resources
• Plans transitions of care for patients and families/significant others of all ages in any patient care setting
• Provides psycho-education
• May facilitate support groups
• Provides consultation on psychosocial aspects of care as a member of the interdisciplinary team
• Serves as a liaison to community programs
• Collaborates with multidisciplinary treatment on discharge planning
• May provide education to staff and other hospital departments
• Participates on committees as requested

Requirements

• Master’s degree in Social Work
• 2 years of recent relevant experience

Skills

• Clinical skills in biopsychosocial assessment and clinical interventions, including crisis intervention, intervention with patient/family behavioral issues, grief counseling, supportive counseling, adjustment to illness, life review/end of life support, behavioral change therapy, motivational interviewing, short-term family counseling, group facilitation
• Collaboration skills and ability to work effectively on a team
• Skills in patient and family advocacy
• Knowledge of transitions of care and community resources
• Knowledge of post‑cute levels of care and resource needs for discharge planning
• Knowledge of child, elder and dependent adult abuse, crimes against persons reporting requirements, and other significant regulations affecting clinical social work practice (e.g., Tarasoff, patient confidentiality)
• Knowledge of behavioral health and the skills to assess mental health functioning, high‑risk behaviors, depression, anxiety, or other psychiatric conditions impacting hospitalization or transitions of care
• Knowledge of suicidal behavior, and the skills necessary to assess lethality, and to develop and implement an appropriate plan of care
• Knowledge of substance use and the skills to assess level of addiction, motivation for change, and to develop and implement