Job Description

Overview:
Persbyterian Home Health Hospice/Palliative Social Worker is responsible for the development, planning, implementation and evaluation of psycho/social interventions for patients followed in the Home Health, Hospice IP/OP, and Palliative programs.
This position will be responsible for identifying patients who have complex psycho/social needs, require assistance with eligibility determination for social programs and funding sources and who may qualify for community assistance from a variety of special funds and agencies. In addition, the Hospice/Palliative Care Social worker operates as the mental health professional of the team. All interventions are aimed at improving Quality of Care/Life and decrease complications and readmissions. The HPSW offers crisis intervention to patients and families with psychosocial needs and coordinates and facilitates the development of a plan of care for all patient populations. This role will receive referrals and consults for patients from at risk populations from interdisciplinary team members, including physicians, Case Managers, staff nurses and other members of the care team, in addition to case findings. Social work interventions and services may be assigned in person, via phone, and/or via telehealth means.
Full Time and Part-Time positions available
Exempt: No
Work Schedule: Varied Days and Hours
Responsibilities:
Responsibilities:

• Provides Home Health, Hospice IP/OP, and Palliative Social Work across the outpatient and inpatient settings.
• Based on the referral, consultation or case finding assess patients and family s psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, reaction to illness and ability to cope.
• Completes Psychosocial assessment and provides psychosocial interventions.
• As active participant of IDT contributes to and manages the patient plan of care. Provides strengths-based person and family center of care.
• Intervenes with patients and families regarding emotional, social, and financial consequences of illness and/or disability, provides psychoeducation.
• Provides supportive counseling to patients / families experiencing and/or anticipating issues to adjusting to illness, catastrophic diagnosis, changes in living situations and bereavement.
• Intervenes with patients demonstrating complicated grief and explores bereavement related to possible death and multiple aspects of loss and adaption along the continuum of care.
• Provide anticipatory guidance.
• Provides non-pharmalogical pain and symptom management, reinforces patient and family personhood and coping as they negotiate complications with chronic illness and end of life.
• Assist Hospice Chaplain with developing plan of care.
• Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the health care system.
• Facilitates family meetings.
• Participates in discharge planning activities in collaboration with other staff for patients, to ensure a timely discharge and to provide appropriate linkage with post-acute providers.
• Provides clinical guidance and consultation to interdisciplinary primary teams, including social workers, and case managers, prompting continuity of care as well as safe and comprehensive care coordination and discharge planning as indicated.
• Works with families exhibiting complex family dynamics that impact directly on patient care and discharge.
• Educates patient/family and interdisciplinary team regarding post-acute options and addresses issues of choice.
• Actively participates and provides pertinent information in complex rounds discharge planning huddles, case conference, and whiteboard rounds.
• Provides intervention in child abuse/neglect, domestic violence, guardianship-temporary/ permanent, foster care, adoption, mental health placement, advance directives, adult/elderly abuse, child protection and sexual assault.
• Supervise and mentor Social Workers enrolled in Master level programs to fulfill practicum clinical hours for licensure and diploma requirements.
• Participates in on call rotation as required by department.
• All other responsibilities as assigned by supervisor.
• In Regional departments as applicable and directed by supervisor
• Coordinates volunteers and provides bereavement services to patients/families and community.

Volunteers Services * Serves as the hospice volunteer coordinator to be responsible for the following:
*Recruit and retain volunteers for Hospice. * Provide training, education and orientation to new Hospice volunteers.

• Coordinating with HR to ensure volunteers are trained and receive appropriate background checks and health immunizations.
• Hold monthly meetings for education and retention of current volunteers.
• Facilitate assessment for volunteer placement in patient homes.
• Coordinate volunteers in pt homes and assist with communication between volunteers and IDT members.
• Community outreach events to educate community regarding the needs for Hospice volunteers and Hospice education.
• Managing Desk File for Hospice volunteers in compliance with Hospice Conditions of Participation.
• Managing and recording hospice volunteer hours worked to reach 5%.
• Monthly education to current Hospice volunteers to demonstrate competency.
• Assist Hospice Chaplain with developing plan of care.
• Bereavement Services
• Serves as the Bereavement Coordinator as needed to be responsible for the following:
• Bereavement assessment post-mortem.
• Develop bereavement plan of care based on assessment.
• Bereavement visits and phone calls based on bereaved plan of care.
• Supervising bereavement program and/or volunteer with bereavement mailings.
• Make referrals to outside sources of support for intensive bereavement counseling.
• Assist with adjustment and transition to survivors of bereaved.
• Performs other duties as assigned.

Qualifications:
Social Worker MSW III

• Masters degree in Social Work required.
• Current license from the State of New Mexico as a Licensed Clinical Social Worker-LCSW, Licensed Independent Clinical Social Worker-LICSW or Licensed Master Social Worker-LMSW.
• 10 years hospital social work or discharge planning experience in relevant setting.
• Working knowledge/experience in case management.
• National Case Management certification or SW Palliative Care Certification; ACHP-SW or APHSW-C preferred.

Social Worker II

• Masters degree in Social Work required.
• Current license from the State of New Mexico as a Licensed Clinical Social Worker-LCSW, Licensed Independent Clinical Social Worker-LICSW or Licensed Master Social Worker-LMSW.
• 5 years hospital social work or discharge planning experience in relevant setting required.
• 1 year hospital social work experience, protective services, or practicum in acute care settings experience desired.
• National Case Management certification or SW Palliative Care Certification; ACHP-SW or APHSW-C preferred.

Social Worker I

• Masters degree in Social Work required.
• Current license from the State of New Mexico Licensed Master Social Worker-LMSW.
• 1 year hospital social work experience, protective services, or practicum in acute care settings experience desired.
• National Case Management certification or SW Palliative Care Certification; ACHP-SW or APHSW-C preferred.

Benefits:
We offer more than the standard benefits!
Presbyterian employees gain access to a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more!
Learn more about our employee benefits:
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans. For our employees, we offer a robust wellness program, including free access to our on-site and community-based gyms, nutrition coaching and classes, wellness challenges and more.
Presbyterian's story is really the story of the remarkable people who choose to work here. The hard work of our physicians, nurses, employees, board members and volunteers grew Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system that serves more than 875,000 New Mexicans.
About Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. We are a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1,600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
About Our Regional Delivery System
Presbyterian's Regional Delivery System is a network of six hospitals and medical centers throughout rural New Mexico including locations in Clovis, Espanola, Ruidoso, Santa Fe, Socorro and Tucumcari. Our regional facilities are home to more than 1,600 clinical and non-clinical employees who help make Presbyterian the state's largest private employer with nearly 14,000 statewide employees. With a variety of services ranging from general surgery to pediatrics to heart and cancer care, our regional employees are proud to provide close-to-home care for their communities.
We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come.
About New Mexico
New Mexico continues to grow steadily in population and features a low cost-of living.
Varied landscapes bring filmmakers here from around the world to capture a slice of the natural beauty New Mexicans enjoy every day. Our landscapes are as diverse as our culture - from mountains, forests, canyons, and lakes, to caverns, hot springs and sand dunes.
New Mexico offers endless recreational opportunities to explore and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to: USD $45.82/Hr. Compensation Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.

Skills Required