This is a professional position responsible for the provision of a wide range of psychosocial services to patients and their caregivers in order to maximize the patient’s capacity to cope with problems of daily living resulting from their medical condition. When a referral is received, the Social Worker is responsible for completing a psychosocial assessment, a medical social worker evaluation, and completing a Medical Social Worker Evaluation and Physician Authorization. Upon completion of the assessment, a psychosocial plan of care is developed with the patient/significant other. It is the role of the social worker to implement, revise the plan relative to the psychosocial issues that may interfere in the patient reaching an optimum level of functioning. The services provided may include: problem solving, community resource education and referrals, short term counseling, and assisting the physician, patient, caregivers and health care team members to understand the social environmental and emotional factors related to the patient’s health problems.

• Conduct initial evaluation of patient in a thorough, accurate, and compassionate fashion.
• Function as a support person for the patient/caregiver.
• Function as an expert and facilitator at obtaining and making referrals to community resources to meet the needs of patients and caregivers and obtaining financial assistance when indicated.
• Coordinate community resources.
• Assist patients with Advanced Directives education and forms.
• Assist family/caregiver in placement of patient in a facility for basic care, respite or inpatient when appropriate.
• Provide psychosocial counseling to patients, relative to the impact and implications of their disease and patient care.
• Attend and actively participate in staff meetings and in-services and contribute positively to patient care planning.
• Works in concert with other team members.
• Provide and maintain a safe environment for the patient.
• Assist patient/caregiver and other team members in providing continuity of care.

• Coordinate travel time for visits and manages a caseload to deliver care in a cost-effective manner that demonstrates an understanding of home health reimbursement methodologies.
• Assure proper maintenance of records per agency guidelines.
• Maintain regular attendance
• Function independently, but seeks and accepts guidance from supervisor, other members of the team and members of the community, as deemed necessary and appropriate.
• Comply with state and federal guidelines and Agency policies and procedures.
• Conduct all business activities in a professional, ethical and confidential manner.

• Has a Master of Social Work (MSW) degree from a school of social work accredited by the Council on Social Work Education.
• Minimum of 1-2 years of experience in a healthcare setting, preferably in home health or hospice care.
• License to practice social work in the Commonwealth of Pennsylvania (LSW).
• CPR certified.
• Must be a licensed driver with an automobile in good working condition and have automobile insurance in accordance with PA laws.
• Satisfactory references from employers and/or professional peers.
• Satisfactory criminal background check.