The Social Worker provides direct social work to all areas of the organization.  The Social Worker provides services to patients and families, via assessment, discharge planning, interdisciplinary collaboration, advocacy, and referral. The social worker will coordinate with case management to assure appropriate continuity of care.

The Social Worker reports directly to Director of Population Health.

1. Evaluate patients’ social, emotional, and mental health needs that impact their ability to access and benefit from medical care. Act as a liaison between patients and healthcare providers to ensure patients’ concerns are understood and addressed. Collaborate with        healthcare teams to create individualized care plans that consider both medical and social needs.

2. Help patients access community resources like housing, transportation, food assistance, and financial aid to support their health and well-being. Will coordinate referrals to mental health services, substance abuse programs, or social services as needed.

3. Educate patients about healthy lifestyle choices, disease management, and preventive care. Provide counseling or emotional and psychological issues, such as anxiety, depression, or coping with chronic illness.

4. Build and maintain relationships with local agencies and organizations to create a network of support for patients. Participate in or lead community outreach programs to raise awareness of available healthcare and social services. Participate in organizations’ health      care initiatives for improved health outcomes for patients. Help organize or participate in community health screenings and wellness events, often focusing on underserved populations.

5. Document patient interactions, assessments, interventions, and referrals in the electronic health record. Ensure compliance with local, state, and federal regulations, and report patient progress to the healthcare team.

6. Work with culturally diverse populations, understanding their unique barriers to care and providing appropriate resources. Help patients overcome language barriers by coordinating interpreters or providing information in the patient’s native language.

7. Other duties as assigned.

1. Education:
  a.) Bachelor’s degree in Social Work, or in related field such as psychology or sociology.

2. Licensure/Certification:
  a.) BLS certification.

3. Work Experience:
  a.) Two years of hospital social work experience preferred or other pertinent social work experience.