SUMMARY: The Social Worker is an active participant of the Care Coordination Team. The position assesses patients and works with the Medical Team to complete behavioral health assessments, patient follow ups, review social determinants, set/follow up on outside referrals, patient education, and assist with behavioral interventions.

MAJOR DUTIES:

Serves as a liaison between the patient, medical practitioner and the mental health provider.

Develops a comprehensive social history and psychosocial assessment that includes the patient's problems and strengths and preferences, including cultural, religious, and ethnic background and implications for the care plan.

Receives documentation from providers and follows up with patients regarding their treatment plan.

Sets up and attends meetings with providers and patients as needed.

Active participant in the patient care coordination team and Care Team Huddles.

Provides crisis management intervention.

Provides linkage with appropriate community resources by maintaining knowledge of other systems, making referrals, and identifying unmet needs.

Orients new patients to GSCC and walks them through the patient handbook.

Maintain complete and accurate records on each patient using the EMR.

Maintain patient confidentiality.

Understands and abides by HIPAA guidelines.

Delivers behavioral health education services. Develops educational materials such as audio-visual aids, articles, brochures, fact sheets and public service announcements promoting behavioral health topics.

Collect and analyze data from various sources to evaluate programs and determine need for additional educational programs or communications.

Work with Trauma Informed Care Teams to solve community health issues.

May be asked to provide input on grant proposals and report on program progress.

Performs other duties as assigned.

DESIRED QUALIFICATIONS:

Bachelor’s degree in social work.

Excellent written and verbal interpersonal communication skills and ability to communicate complex information.

Excellent computer, documentation and customer service skills.

Must be able to stand for long periods of time.

Highly-motivated, well-organized and detail-oriented, and able to manage multiple responsibilities in a fast-paced environment, while maintaining a high degree of professionalism with diverse constituencies.

Full COVID-19 vaccination required