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Title

Hospice Care Social Worker, Washington DC 

EOE StatementWe are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.
 
Description

Hospice Care Social Worker needed for part-time (20 hr/week), temporary (without end date), hybrid position in Washington DC.

Provides social service counseling and guidance to facilitate the maximum function and coping capacity of each patient and involved caregiver while following all policies and protocols, in accordance with the interdisciplinary plan of care. Provide compassionate care, advocacy, and psychoeducation from diagnosis to death through bereavement.

Responsibilities

1. Assist the core members of the pre-hospice/hospice team in understanding significant social, spiritual, and emotional factors related to the patient's health, to establish a plan of care which fosters the personal worth, spiritual well-being, and human dignity of each patient

2. Participate as a member of the interdisciplinary team and in the development and review of the plan of carefor assigned patients

3. Assess the social, spiritual, and emotional needs/factors in order to estimate the patient's and involved caregiver's capacity and potential to cope with the problems of daily living and with the terminal diagnosis and illness 4. Help the patient, family, and involved caregiver to understand, accept and follow medical recommendations and provide services planned to assist in achieving the optimum social, spiritual, and health adjustment within their capacity and level of health literacy

5. Prepare the patient to deal with the changes and the family to support the patient including education on Advanced Directives

6. Utilize all available resources, such as family, hospice, and community agencies, to assist the patient and family to live better within the limitations of the illness

7. Support the bereavement program at the site level, including, but not limited to:

a. Completing bereavement calls and visits to offer counseling and support

b. Facilitating bereavement support groups in the community, including an annual memorial service; c. Participating in the?monthly bereavement committee meetings;

d. Keeping the bereavement binder up to date (with meeting minutes, sign-in sheets fromgroups/workshops, etc.)

8. Provide discharge planning related to change of level-of-care or community placement

9. Observe, record, and report social, spiritual, and emotional changes, documenting all services in patient'selectronic medical record

10. Will participate in the on-call rotation and provide after-hours coverage as specified by needs of the agency 11. Other duties as assigned

Inpatient Hospice Center (IPC)

12. Ensures patient smoothly transitions from one hospice level of care to another

13. Serves as a patient navigator and contact for patients during transition

14. Facilitates care meetings in collaboration with hospice physician, team manager, patient, and involved care giver to ensure smooth delivery of hospice services, care coordination, advanced care planning and counseling for withdrawal of medical interventions

15. Develops and maintains effective working relationships with care teams that generate superior clinical and business performance

Palliative Consult Service

16. Serves as an integral member of the healthcare team providing assessments, coordination, treatment planning, information and referral to community resources and other social work services to meet the complex needs of a patients and families in the hospital, home, and post-acute setting

17. Provide counseling for disease acceptance and understanding

18. Takes, reviews, evaluates and prioritizes written and oral referrals

19. Maintains documentation records and data collections across all clinical records including Hospice electronic medical record and the host hospital system

20. Serves as a liaison between patient and Hospice for maintaining positive relationship with Hospice and providing continuity of care

21. Ensures patient smoothly transitions from one area of care to another; serves as a patient navigator and contact for patients during transition

22. Coordinates/schedules the team interview/consult with the patient and involved care giver 23. Develops and maintains effective working relationships with care teams that generate superior clinical and business performance

Pre-Hospice

24. Assists the clinician in execution of the care plan in the area of psychosocial issues as needed, including routine and emergent visits as assigned

25. Telephonic, virtual and or face-to-face evaluation of patient's psychosocial status when needed 26. On-going evaluation of patients' social determinants of health

27. Education of the patient and family on how to proactively manage symptoms, as well as how to respond appropriately in times of crisis with an emphasis on utilizing palliative in-home support and other lower acuity interventions when appropriate

28. Gather information regarding appropriateness for other services to best meet patient needs 29. Facilitation of referrals to community resources, both formal and informal to address the patient's needs and as directed by the patient's care plans

30. Navigation support for patients as they manage the healthcare continuum, including maximizing insurance benefits to promote healthcare needs

31. At time of discharge, management of the transfer of patients from the pre-hospice program to the appropriate referral source, including to hospice or primary care providers

32. Collaborate with the rest of the team including alerting the team to changes and newly identified patients needs as they arise

 
Position Requirements

Master of Social Work (MSW) degree required

At least one (1) year of social work experience in a health care setting: 2+ years preferred 4. Medicare/Medicaid/Insurance specialty preferred

Must have reliable transportation, a valid driver’s license, and the minimum state required liability auto insurance 6. Additional Qualifications for Pre-Hospice Social Worker: Experience with coordination of insurance benefits (such as a Medicaid Specialist) preferred

 

This position is currently accepting applications.

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