Social Work Care Managerrovides psychosocial assessment of patients, for post hospital discharge needs including homecare, nursing home placement, durable medical equipment, financial assistance, counseling, and other community resources. Ensure appropriate decision makers are informed of and involved in treatment planning.
Provides psychosocial assessments of patient/family situations including social, psychological, emotional, financial and other related factors to facilitate patients return to the community.
Evaluates psychosocial and medical/nursing information to determine an appropriate social service action/discharge plan.
Assists patient/family in utilizing appropriate community resources.
Documents patient information in EHR and/or other electronic system in accordance with program standards, department policies/procedures.
Performs supportive counseling to assist patients/families in adjusting to disability and illness, and for realistic planning for post hospital care.
Performs basic administrative tasks including statistical reporting and other related tasks.
Ensures communication of patients psychosocial needs for post hospital care.
Community account management for community referrals and to increase HealthEast hospice census.
Assist Hospice teams with community relationships by building partnerships with facility staff and others involved
Create on gong schedules and follow up plans with assigned facilities and others to manage the relationships created
Responsible for tracking, reporting, and meeting the requirements for the 1 hour of 1:1 and group supervision provided per month.
Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards.
Actively participates in creating and implementing improvements.
Performs other responsibilities as needed/assigned.
Bachelor's degree in Social Work from an accredited school of social work.
Licensed Social Worker (LSW)
1 year of hospital social work experience or 2 years of nursing home experience required.
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership ...with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.