Medical Social Worker BSW Infectious Disease

The Case Manager provides support services to patients receiving care for HIV/AIDS within the HealthPartners Infectious Clinic. Working as an integral member of the multidisciplinary care team, this position helps patients fully engage in their medical care. This goal is achieved by assisting with medical care coordination and providing support to patients to help address psychosocial needs and reduce barriers to care. Required Bachelor’s degree in Social Work from a CSWE accredited program and State of Minnesota Licensure or license eligible. Minimum of two years of experience working with adults with chronic disease, seniors and/or home care. Working knowledge of, and experience with, family systems theory, individual and family counseling, and group process. Knowledge of Community Resources including Medicare / Medicaid, financial aid, county, state, and private social service agencies. Clinical Social Work experience with individuals and families. Ability to work well with interdisciplinary team. Ability to work independently, take initiative and think creatively. Excellent oral, written and interpersonal communication skills. Current MN Drivers License and car. Preferred Five or more years of relevant professional Social Work experience. Physical Requirements Ability to make mobility to all GHI clinic and hospital sites. Ability to communicate with patients and families. Position Purpose Service excellence is to be centered on patient care and patient relationships and is the responsibility of all employees. Teamwork is the norm and all employees will be held accountable to work as effective team members. This position provides social work services for moderately complex adult cases. Job Functions Screen and identify potential candidates for program participation. Perform client intake services. Develop client service plans in compliance with funder requirements. Identify and work to resolve barriers clients may encounter (language barriers, eligibility criteria, services fees, geographic location). Provide resources and referrals necessary for clients to obtain and/or maintain access to HIV medical care. Conduct reevaluation and follow up assessment throughout length of care in compliance with funder requirements. Provide outreach to client’s family, friends, and significant others. Maintain consistent contact (office visits, home visits, and telephone calls) with clients to sustain ongoing supportive relationships. Partner closely with care team to implement service plan and to assure all team members are informed of clients’ needs and medical status. Document services provided in a manner compliant with funder requirements. Complete reports on services used and services needed by clients. Maintain a level of knowledge and skills required to perform all duties in compliance with Ryan White case management and grant standards. Knowledge of HIV transmission and safer sex. Knowledge of health, safety, behavioral, and the emotional implications of HIV/AIDS diagnosis. Other duties as assigned. Major Accountabilities Social Work assessments. Information and referral for community resources to patients and families. Social Work consults with GHI providers. Case management, including case managing patients living with HIV. Short‑term counseling and/or pre‑therapy. Provide social work services to patients in line with department policies and procedures. Duties as assigned by the Supervisor. Specific Accountabilities Social Work assessments. A. Assess patient’s situation in regard to social history, social resources, financial resources, environment, self‑care capacity, mental/emotional status, strengths and weaknesses of psychosocial adjustment. B. Facilitate establishment of plan to meet client’s needs with family, GHI and available community resources. Make appropriate referrals. C. Assist family in accessing available resources. D. Documentation and daily logs as indicated in Policy and Procedure Manual. Information and referral for community resources to patients and families. A. Establish and maintain resource file by county. B. Establish contacts at county and community agencies to maintain updated information on programs. C. Maintain up‑to‑date knowledge of financial resources in the community. D. Assess patient / family needs and facilitate connection with appropriate community resources. E. Documentation and daily logs as indicated in Policy and Procedure Manual. Social service consults with GHI providers. A. As appropriate for each individual patient: 1) Provide appropriate information to provider; or 2) Provide telephone assessment and referral to patient or family; or 3) Schedule home or clinic visits with patient for further assessment and referral or case management. B. Documentation and daily logs as indicated in Policy and Procedure Manual. Case management. A. Assist primary MD in case management as needed. B. Maintain knowledge of GHI contract benefits. C. Maintain knowledge of eligibility requirements for Medicare, Medicaid, SSI / SSDI, and other county, state and federal program requirements and services. D. Maintain knowledge of and working relationships with GHI providers, departmental resources and referral procedures (behavioral health, discharge planning, member services, etc.). E. Attend case conferences as requested and appropriate. F. Documentation and Daily Logs as indicated in Policy and Procedure Manual. Short‑term counseling or pre‑therapy. A. Assist patient and family members in identifying psychosocial issues/impacts of their situation, facilitate expression and communication of emotional reactions, initiate problem‑solving process. B. If patient/family situation dictates ongoing therapy needs (more than 1‑3 visits) refer to GHI behavioral health or appropriate community resource. C. Documentation and Daily Logs as indicated in Policy and Procedure Manual. Provide social work services to patients in line with department policies and procedures. A. Provide social work services listed above as part of the departmental team. B. Documentation and daily logs as indicated in Policy and Procedure manuals. Assist Supervisor in development of Social Work Program for GHI. A. Assist in outreach to aid education of GHI providers about available social work services. B. Assist in developing recommendations for the GHI system. C. Other projects as appropriate. Assist Supervisor in other areas of the Social Work Program as assigned. A. May include Info. /Referral, Social Work Assessment visits and case coordination. #J-18808-Ljbffr