Social Worker LMSW
Company: Methodist Health System
Location: Council Bluffs
Posted on: March 19, 2023
Why work for Nebraska Methodist Health System?
At Nebraska Methodist Health System, we focus on providing
exceptional care to the communities we serve and people we employ.
We call it The Meaning of Care - a culture that has and will
continue to set us apart. It's helping families grow by making each
delivery special, conveying a difficult diagnosis with a
compassionate touch, going above and beyond for a patient's needs,
or giving a high five when a patient beats a disease or conquers a
personal health challenge.
We offer competitive pay, excellent benefits and a great work
environment where all employees are valued! Most importantly, our
employees are part of a team that makes a real difference in the
communities we live and work in.
Social Work is a professional and academic discipline that seeks to
improve the quality of life and subjective well-being of
individuals, and communities.
Properly identifies patient problems, needs and barriers to care
and coordinates the selection of appropriate services.
Essential Job Functions
Psychosocial management - Complete psycho-social evaluation of the
patient and family system. Properly identifies patient's likelihood
of needing post hospital services and availability of those
services ensuring a smooth and safe transition at discharge.
- Assists in the development of the discharge plan with
patient/family and interdisciplinary team.
- Provides complete functional, psychosocial assessment within 24
working hours of referral, order or identification of a
- Ensures services provided are consistent with the patient's
- Performs an ongoing assessment of the patient, support system,
and environment to determine factors that impact the patient's
ability to maintain the highest level of independence.
- Facilitates discharge planning by documenting an accurate
picture of patient's discharge needs, services offered and any
barriers to discharge or plan of care from being implemented or
carried out. Continuity/Transition Management - transitioning of
the patient to the appropriate level of care needed. Provides
assistance with discharge planning - identifies appropriate
agencies/facilities for patients requiring assistance at home or
placement at another level of care.
- Maintains a level of expertise and current knowledge base on
available community resources and services available.
- Informs patient/family of services available and initiate
services that are consistent with patient's identified needs to
maintain the highest level of independence.
- Documents and discusses the results of evaluation with
patient/family. Seeks input from other healthcare facilities and
professionals who may provide care before admission.
- Documents and informs patient/family of their freedom to choose
providers of post hospital care and respect preferences.
- Provides and documents a list of agencies available that serve
the geographical area requested by the patient. (HHA, SNFs).
Discloses to patient/family if the hospital has any financial
interest with post hospital agencies.
- Initiates services that are consistent with the patient's
identified needs by providing referral to appropriate resources as
soon as recognized.
- Effectively communicates with agencies/facilities of the
patient needs. Provides access to electronic medical record to
agencies/facilities. Completes PASSR for nursing home
- Provides referral to appropriate community resources as soon as
recognized to meet identified patient's discharge and financial
- Provides appropriate information through Ensocare to
- Keeps patient/family informed of anticipated discharge and
changes in discharge plan. Participate in the development of a
discharge plan and assesses the effectiveness
- Collaborates with physician, interdisciplinary team and
patient/family to develop comprehensive, proactive discharge plans
for all complex patients.
- Participates in daily huddles and unit rounds and effectively
communicates any barriers to discharge with patient/family,
physician and interdisciplinary team.
- Collaborates with interdisciplinary team to ensure barriers are
addressed and ensure a safe discharge occurs. Initiates appropriate
interventions to ensure the patient/family of a safe discharge.
- Identification of financial needs that impact the patient's
ability to meet their financial responsibility and initiates
- Identify and assist patient in obtaining necessary durable
medical equipment to ensure a safe discharge.
- Completes PASSR for nursing home admissions.
- Performs mini mental exams as requested to assist appropriate
safe discharge. Ensure that proper committal procedure
- Assist physician and patients/families in advance directive and
end of life discussions and assure that proper documentation
obtained. Initiate appropriate referral to assist with completing
advance directives, guardianship, disability assistance etc.
- Provides immediate counseling of patients and family and
effectively diffuses crisis and refers to appropriate services for
abuse/neglect as needed to include APS, CPS.
- Assist physicians, patients and families with adoption
- Assist physicians, patients and families with coordination of
dialysis needs. Advocacy & Education - ensuring the patient has an
advocate for needed services and any needed education. Promotes the
education of all members of the interdisciplinary team,
physicians/office staff, and patient/families
- Provides patient/family education and counseling about existing
health problems and related care.
- Promotes the education of all members of the interdisciplinary
team, physicians and office staff, community providers and
patient/families to Social Worker responsibilities.
- Acting as resource to staff for counsel, education and referral
for access to the most appropriate care.
- Provides ongoing education based on needs assessment -
including use and understanding of community resources, issues
related to funding and areas of patient choices and
- Communicates issues/trends (positive/negative) to
Director/Supervisor. Participates in new employee orientation.
- Willingly performs other duties as assigned. Participates in
the development and implementation of community collaboration based
on evidence-based practice that includes Methodist Jennie Edmundson
Hospital core values, readmission efforts, decreasing length of
stay efforts, and improving communication with the community.
- Assures that the core values, readmission, LOS, communication
efforts are a community process and that the guidelines are well
- Knowledgeable of community care efforts to decrease
readmissions, appropriate ED utilization and admissions.
- Makes appropriate referrals to community providers through Tav
- Coordinates community meetings to meet the needs of the
community effort that benefit the patient and/or family through the
episode of illness from pre-hospital to post-hospital care.
- Utilizes Tav Connect to document community resources and
barriers of high-risk patients. Participates in Readmission and
Chemo Huddles to ensure appropriate utilization of resources,
appropriate setting for care and opportunities to decrease
- Provides concerns or barriers with community partners so
communication will occur as soon as problems or concerns are
- Master's Degree in Social Work (MSW) from an accredited school
of Social Work required.Experience
- Minimum of 2-3 years prior healthcare-related social work
- Licensed Master Social Worker (LMSW)
Keywords: Methodist Health System, Council Bluffs , Social Worker LMSW, Healthcare , Council Bluffs, Iowa
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