Job Description

Job Summary

The Social Worker provides therapeutic interventions and social work services to patients and families to enhance comprehensive, integrated, and uninterrupted care throughout the hospital experience and ensure continuity of care in the community. The Social Worker conducts psychosocial assessments, coordinates care planning, and supports patients through adjustment to illness and major life transitions.

Essential Duties & Responsibilities

Psychosocial Assessment & Intervention

• Conducts psychosocial assessments of patients and families to identify needs related to medical conditions, social determinants of health, and overall functioning.
• Interviews patients, families, and significant others to determine the need for social work services and develop appropriate treatment goals.
• Participates in multidisciplinary rounds, providing psychosocial context and input into patient care planning.
• Serves as a resource and advocate for patients and families during discussions on Advance Care Planning.
• Provides preventive, protective, and supportive services to patients facing situations detrimental to their well-being.

Patient & Family Support

• Offers psychosocial support during adjustment to illness, hospitalization, and major life changes.
• Collaborates with healthcare team members to address in-hospital needs and post-hospital care requirements.
• Maintains up-to-date knowledge of psychosocial programs and services, providing relevant information to patients, families, staff, and community organizations.
• Develops and maintains strong working relationships with community agencies.

Discharge Planning & Care Coordination

• Coordinates comprehensive discharge planning to ensure continuity of care and access to appropriate aftercare services.
• Arranges placements or referrals for Long-Term Care, Acute Rehab, Sub-Acute Rehab/SNF, LTAC facilities, Dialysis, Hospice, and Homelessness resources.
• Ensures timely communication with patients, families, and interdisciplinary team members regarding discharge needs.

Documentation & Compliance

• Completes psychosocial assessments, progress notes, family intervention summaries, and discharge planning documentation in accordance with department policy, and State, Federal, and Joint Commission standards.
• Assists patients in obtaining governmental and community benefits such as food stamps, financial support, and transitional housing.
• Ensures adherence to confidentiality standards and hospital policies.

Program Evaluation & Improvement

• Evaluates program objectives and participates in continuous improvement initiatives aligned with hospital and departmental missions.
• May accompany patients to access benefits, entitlements, or essential community services.

Required Skills & Competencies

• Excellent communication, negotiation, and conflict resolution skills.
• Knowledge of clinical practice trends, healthcare informatics, and relevant technologies.
• Strong understanding of State and Federal regulations related to social work practice.
• Ability to support rapid cycle change and participate in clinical performance improvement activities.
• Ability to work effectively in a fast-paced, multidisciplinary hospital environment.

Physical Demands

This position requires full range body motion including handling and lifting, standing, walking, manual dexterity, and eye-hand coordination. Normal visual acuity and hearing are necessary. Reasonable accommodations may be made for individuals with disabilities.

Education & Experience Requirements

• Required: Master’s Degree in Social Work (MSW) from an accredited program.
• Preferred: Previous experience as a medical or hospital social worker.
• Required for Practice: New Jersey Social Work License (LSW or LCSW).

Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

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