Work where every moment matters.
 
Every day, almost 30,000 Hartford HealthCare employees come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network as a Social Worker. 

Hartford HealthCare at Home, the largest provider of homecare services in Connecticut, has been fulfilling our mission for more than 115 years. Our Person-Centered Care Model allows our employees to learn and grow within our organization, all while providing integrated support to the patient. As part of Hartford HealthCare, we leverage cutting edge technology to provide quality care in our client’s home. Most importantly, our employees are appreciated for the real differences they make in both the lives of their clients and their clients’ families. 

Our Social Workers (MSW) utilize their extensive education and training to provide personalized care to our patients in a rewarding environment that promotes autonomy. 

 The Home Care Social Worker (LMSW) is a Master’s prepared, Licensed Clinician who will engage patients, in their home, to determine their short and long-term needs, and will provide short-term counseling/interventions to meet care plan objectives. The Home Care Social Worker will collaborate with patients, their families, physicians, and home care team to identify and address patient’s bio-psychosocial needs, barriers to care, risk-factors, etc. The Home Care Social Worker is familiar working with patients who have complex health care and psychosocial problems that require a high degree of clinical oversight and creative problem solving. The Home Care Social Worker works independently and uses critical thinking skills to make accurate, and at times, quick judgments, and has the ability to respond appropriately to crisis situations.

 JOB RESPONSIBILITIES

Key areas of responsibility

Collaborates with the interdisciplinary team regarding patients that were identified for Social Work Services, and through IDT/case communication, assists with identifying patients that would benefit from Social Work Services.

 Completes comprehensive in-home psychosocial evaluations. Evaluations include:

 Consideration of developmental, social and/or cultural, substance abuse, psychological, environmental, and medical issues 

 Physical, social, emotional, and familial characteristics

 Use of evidence-based assessment tools to determine cognitive status and behavioral health needs including Dementia, Depression, Anxiety, etc.

 Home safety, family dynamics, caregiver strain, and other risk factors including suicide

 Patient/family understanding of their disease treatment options

 Strengths, available supports, and barriers to care

 Determine appropriate level of care including needs for long/short-term skilled-nursing facilities, assisted living facilities, adult day care, etc.

 Based on a comprehensive, culturally competent assessment collaborates with the patient and family to create a care plan with measureable goals. Implements short-term interventions to address identified barriers and promote health and well-being.

 Provides clinical treatment services in form of triage, crisis intervention, individual or family therapy, screening and planning

 Utilize Motivational Interviewing and Coaching skills to assist patients/families in identifying and addressing goals. Using identified strengths, encourage self-determination and independence

 Act as educators for patients, families, the community, and other professionals regarding disease prevention, disease progression, impact of illness, health maintenance, and adherence to treatment regimens

 Advocate for the needs and interests of patients to improve access to care and improved delivery of services

 Provide ongoing assessment of patient and family needs. Monitor and alter care plan goals and interventions as necessary

 Maintains timely documentation of social work services, which reflect the patient and client systems’ pertinent information for assessment and treatment; social work involvement and outcomes.

 Facilitates team based care and collaboration

 Work collaboratively with primary care and specialty physicians and other members of the health care team to improve quality of life

 Functions as an integral member of the multidisciplinary team. Participates in case conferences and IDT meetings

 Assists the health care team in understanding social/psychological factors related to patient’s care

 Acts as a consultant for Agency staff regarding abuse, neglect, exploitation, and community resources

 Identify HHC and community-based resources for patients and families as appropriate

 In addition, the position involves other duties such as:

 Participates in Agency staff meetings and appropriate interdisciplinary meetings

 Conducts outreach activities for purposes of program marketing, community education, and collaboration with other service providers

 Act as liaison to other community services and agencies

 Participates in health care programs as required

 Participates in appropriate external and internal professional activities

 Participates in educational activities regarding area of expertise

 Follows Agency procedures in delivering casework services

 Maintains productivity standard