Principle Duties And Responsibilities:
-Conducts a comprehensive assessment of patient and family/caregiver's biomedical, psychological, social and functional needs to gage the potential impact on recovery.
-Develops personalized patient-centered care plans aimed at optimizing the patient's care experience.
-Engages patients and their families as part of the care team through advocacy, ongoing communication, health education, identification of resources and service facilitation.
-Utilizes professional judgment, critical thinking, motivational interviewing and self-management techniques to assist patients in overcoming barriers to goal achievement.
-Provides counseling and interventions related to treatment decisions and end of life issues including Advanced Care Planning.
-Provides coordination as necessary to ensure patients seamlessly and safely transition between care settings.
-Advocates for appropriate delivery of services within the patient's health plan benefit structure.
-Collaborates with appropriate members of the patient's treatment/care team to co-manage patients with complex medical and social needs. Facilitates interdependent collaborate care conferences.
-Continually evaluates the patient's response to the care/treatment plan making modifications when necessary.
-Plans and participates in process improvement activities designed to reduce risk, inclusive of data collection, analysis and follow-up intervention activities.
-Supports department based goals, which contribute to the success of the organization.
-Performs other duties as assigned.
License
Social worker state of RI
BLS
Job Types: Contract, Temporary
Pay: From $62.00 per hour
Work Location: In person
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