What are the responsibilities and job description for the MSW Case Manager position at Healing Hands Home Care?
The MSW for Integrated Health Care Coordination works with individuals and families to assess social, emotional, and financial needs related to their healthcare. The role ensures that patients receive coordinated care, assisting with navigating the healthcare system, managing chronic conditions, and connecting to appropriate services and resources. The MSW works closely with healthcare providers to deliver holistic care that improves patient outcomes.Key Responsibilities : Assessment and Evaluation : Conduct comprehensive psychosocial assessments to identify patient needs, barriers to care, and emotional or social issues impacting health.Collaborate with interdisciplinary teams to develop care plans that incorporate both medical and social needs.Care Coordination : Serve as a liaison between patients, healthcare providers, and community resources.Assist with transitions of care, such as hospital-to-home or inpatient-to-outpatient services, ensuring continuity of care.Coordinate referrals to external services, such as counseling, home health, transportation, or financial assistance programs.Patient Advocacy : Advocate for patients' rights, helping them understand and access healthcare services.Support patients in navigating insurance, benefits, and social services programs.Education and Support : Provide education on managing chronic conditions, preventive care, and available community resources.Offer emotional support, counseling, and crisis intervention to patients and families.Documentation and Reporting : Maintain accurate and up-to-date patient records, documenting assessments, care plans, interventions, and outcomes.Collaborate with healthcare providers in documenting patient care and treatment plans.Collaboration and Teamwork : Participate in interdisciplinary care team meetings to ensure integrated care delivery.Work closely with nurses, physicians, case managers, and other healthcare professionals.Community Outreach : Develop and maintain relationships with community resources to improve patient access to services.Assist with referrals to mental health, substance abuse treatment, and housing resources.Qualifications : Education : Master's degree in Social Work (MSW) from an accredited program.Licensure : Licensed Clinical Social Worker (LCSW) or equivalent licensure depending on the state.Experience : Experience in healthcare settings, particularly in medical social work, care coordination, or case management.Experience working with diverse patient populations, including those with chronic or complex health conditions.Skills : Strong knowledge of healthcare systems, social services, and community resources.Excellent communication, problem-solving, and organizational skills.Ability to work independently and as part of a multidisciplinary team.Proficient in electronic medical record (EMR) systems and documentation.Preferred Qualifications : Knowledge of integrated care models and experience working in a collaborative, team-based environment.Familiarity with behavioral health services, palliative care, or hospice care.Experience with discharge planning, post-acute care, and transitions of care.Physical Requirements : Ability to travel between patient homes, healthcare facilities, and community organizations (if applicable).Ability to sit, stand, or walk for extended periods of time.
