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Social Work Care Manager

Texas Health Huguley FWS
Full-time
On-site
Ocala, Florida, United States
Job Description - Social Work Care Manager (25044346)
Job Description

Social Work Care Manager (Job Number: 25044346)
Description
Benefits

Benefits from Day One

Paid Days Off from Day One

Student Loan Repayment Program

Career Development

Whole Person Wellbeing Resources

Mental Health Resources and Support

Our Promise to You
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose‑minded team. All while understanding that together we are even better.

Schedule: Full Time

Shift: Days

Location: 1500 SW 1 st Ave, Ocala, Florida 34471

The community you’ll be caring for

Horse Capital of the World – Home to the World Equestrian Center

Destination for outdoor enthusiasts (golf, kayaking, horseback riding, nature trails)

Vibrant downtown area with award‑winning establishments

Family friendly with many parks and recreations

Spectacular springs throughout the county

The role you’ll contribute: The Social Work Care Manager intervenes with patients who have complex psychosocial needs, require assistance with eligibility determination for social programs, funding sources and qualify for community assistance from a variety of special assistance programs and agencies, and/or require assistance with transitions of care or discharge planning. In addition, offer crisis intervention to patients and families with psychosocial needs and coordinates and facilitates the development of a discharge plan of care for high‑risk patient populations. This role will receive referrals for individuals from at‑risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care team). The Social Work Care Manager, in collaboration with the patient/family, care manager nurses, nurses, physicians and the interdisciplinary team, ensures patient‑centered care coordination through the continuum of care. The Social Work Care Manager ensures efficient and cost‑effective care through appropriate resources monitoring and clinical care escalations. The Social Worker is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of post‑hospital needs; development of a transition of care plans and initiation of the implementation of the transitions of care plans prior to the discharge of the patient. The Social Work Care Manager is responsible for optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, readmission prevention and length of stay management.

The value you’ll bring to the team
Psychosocial Assessment and Interventions

Assesses patient’s and family’s psychosocial risk factors through evaluation of prior functioning levels, appropriateness and adequacy of support systems, assisting those coping with adjusting to significant life transitions

Intervenes with patients and families regarding emotional, social, and financial consequences of illness and/or disability; accesses and mobilizes family/community resources to meet identified needs

Serves as a resource to provide information and intervention related to treatment decisions, terminal illnesses and end‑of‑life issues

Provides grief counseling and crisis intervention skills

Advocates for patient and family empowerment and independence to make autonomous health care decisions and access needed services within the healthcare system

Provides de‑escalation services for patient/family as appropriate

Provides Motivational Interview techniques for patients with substance use and addictive disorders

Reviews necessary patient information including labs, medications (Pre and post hospital), History and Physical, therapy notes, ED notes, test results and progress notes.

Incorporates the patient/family care goals and preferences as much as possible into the transition of care planning and communicates these goals and preferences to the multidisciplinary team.

Qualifications
The expertise and experiences you’ll need to succeed

Masters in Social Work (MSW)

Minimum three (3) years experience in hospital/medical social work

BLS Certification (preferred)

Licensed Clinical Social Worker (LCSW) (preferred)

ACM/CCM certification (preferred)

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