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Social Worker, MSW

Company: Rocky Mountain Health Care Services
Location: Colorado Springs
Posted on: July 14, 2019

Job Description:

POSITION SUMMARY: The MSW, Social Worker is responsible for planning, organizing and implementing social work services to Rocky Mountain PACE participants and families.

MISSION: Improving lives, Optimizing wellness, Promoting independence

CORE COMPETENCIES:


  • Participant Focus
  • Problem Solving
  • Thoroughness
  • Ethical Conduct
  • Communication Proficiency
  • Personal Effectiveness/Credibility
  • Stress Management/ Composure
  • Teamwork

    RESPONSIBILITIES AND DUTIES:

    ESSENTIAL JOB DUTIES:

    • Responsible for care coordination of hospital and sub-acute admissions and discharges
    • Performs discharge planning coordinating admissions/discharges to contracted facilities for rehab, and permanent placement as needed
    • Works with hospital staff, facility employees, and medical teams to ensure smooth admission and discharge of the participant

    • Works closely with the PACE transition team to ensure that all participant family members and MDPOA/Guardian is informed and active in the discharge process, when appropriate.
    • Builds rapport and relationships with all community partners while providing excellent care coordination of the participant.
    • Maintains best practice and ethical social work according to NASW standards with all professionals and support systems involved in the participants care coordination
    • Acts as liaison with participant and caregivers regarding orientation to and ongoing relations with interdisciplinary team, day center, and other Rocky Mountain PACE staff, including volunteers
    • Provides ongoing support and education to participants and family regarding a variety of issues, including but not limited to the aging process, dementia, grief and loss, end of life, disease processes, difficult family dynamics, and changing roles
    • Works to maintain participant housing through intervention with participant, caregivers, and housing. Will proactively work to partner with participant and/or caregivers to maintain appropriate housing and assist participant to function at most independent community level possible
    • Performs home visits as needed to assess living environment, support system, and safety of the participant.
    • Provides referrals and assessments with contracted personal care boarding homes and assisted living residences
    • Facilitate participant move between residences or assisted care facilities if no other family or support systems are present
    • Initiates referrals to external resources with community agencies such as Adult Protective Services, Housing Authority, or public utility companies
    • Assists participants and caregivers to complete MDPOA, Proxy, and DNR directives as needed
    • Assists participants and caregivers to set up and maintain personal needs accounts
    • Maintains current documentation in participants electronic medical records including change of status; temporary or permanent placements; hospital discharges; participant staffings; home visits; and other significant events
    • Assists participants with SSI and SSDI application process as needed.
    • Refers potential voluntary disenrollment due to dissatisfaction to the participants primary social worker.
    • Assists participants and family in coordination with Rocky Mountain PACE Medicaid Department to keep resources within guidelines for Medicaid eligibility
    • Provide supervision to student interns in MSW internship collaborations between their respective universities and RM PACE
    • Other duties as assigned

      ORGANIZATIONAL (CORE RATING FACTORS):

      • Demonstrates support of the Companys Mission, Vision and Core Values
      • Provides Exceptional Customer Service
      • Ensures discretion with confidential information in accordance with HIPAA guidelines
      • Supports a collaborative work environment including courteous, helpful and professional behavior

      • Embraces Organizational Excellence through practicing individual time management, efficiency and effectiveness and participating in continuous improvement efforts
      • Adheres to and supports all Company policies and procedures
      • Supports and practices safe work habits in accordance with policies and procedures
      • Brings ideas, problems and concerns forward and participates in resolution and implementation
      • Participates in and completes regulatory compliance trainings within the prescribed deadlines
      • Attends required meetings
      • Maintains skills and knowledge required including written and verbal communication, best practices for industry standards, and computer competency

        QUALIFICATIONS AND REQUIREMENTS:

        • Masters Degree in Social Work
        • A minimum of one year of experience working with frail or elderly population is required
        • Experience working on a multidisciplinary team preferable
        • Must have a current drivers license and driving record must be in compliance with Company policy
        • Experience documenting in an Electronic Health Record preferred

          PHYSICAL DEMANDS AND WORKING CONDITIONS:

          The physical demands and working conditions described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

          • Physical Requirements - Requires full range of body motion, manual and finger dexterity, and eye-hand coordination; requires the ability to use department equipment, to communicate effectively; requires standing, walking, sitting (possibly for long periods of time) and performing repetitive tasks (including working on the computer) for up to the entire work day; requires the ability to lift/carry up to 30 pounds using appropriate body mechanics.
          • While performing the duties of this job, the employee is frequently required to stand; walk; lift heavy objects; sit; use hands to finger, handle or feel objects, tools, or controls; talk, see, hear and smell. Requires full range of body motion, manual and finger dexterity, and eye-hand coordination; requires the ability to use department equipment, to communicate effectively; The employee is occasionally required to reach and stretch with hands and arms; climb or balance; and stoop, kneel, crouch, or crawl. The employee may be required to endure extremes in temperature and may work in hazardous environments where personal protective equipment is required. Requires the ability to lift/carry up to 30 pounds using appropriate body mechanics.
          • Visual, Hearing and Communication Requirements - Requires corrected vision and hearing to within normal range, with or without reasonable accommodation. Must be able to communicate effectively in verbal and written form with all levels of personnel within and outside of the organization.

          • Pressure Factor - Requires working under stressful conditions. Moderate pressure to meet scheduled and recurring deadlines.
          • Environmental Conditions Working conditions may be noisy with fluctuating indoor temperatures. Must have the ability to work under moderate pressure in order to meet scheduled appointments or deadlines while dealing with frail, disabled and/or confused participants/clients. Subject to individuals who may have the potential for physical or verbal aggression. May be exposed to a risk of bodily injury through contact with moving instrumentation, toxic substances, medicinal preparations, bodily fluids, communicable diseases and other conditions common in a clinic environment. Subject to unpleasant odors.
          • Environmental Conditions Working in a closed office environment. Work space may be shared. Working conditions may be noisy with fluctuating indoor temperatures. May be exposed to a risk of bodily injury through contact with moving instrumentation, substances and other conditions common to an office environment.

Keywords: Rocky Mountain Health Care Services, Colorado Springs , Social Worker, MSW, Healthcare , Colorado Springs, Colorado

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