Social Work Care Manager

Cincinnati Children's Hospital Medical Center • Cincinnati, OH • 2h ago

JOB RESPONSIBILITIES

Psychosocial Assessment- Conduct a comprehensive psychosocial assessment of the patient's/family's health and psychosocial needs while exercising an intuitive understanding of complexity and uniqueness to identify strengths, challenges, and opportunities. Identify cases that meet criteria for need of care coordination through the comprehensive needs assessment. Stratifies patients to match client needs to the most cost effective model of care coordination. Exhibits advanced interviewing and therapeutic intervention skills with regard to abuse, neglect, and/or other safety risk factors. Report suspicions of abuse and neglect to legally mandated authorities for investigations. Completes documentation with accuracy and clarity.

Resource Management- Partner with the patient/family/caregivers in obtaining financial assistance, community resources, and/or specialized equipment. Develops resource networks, excels at resource utilization, and acts as a resource to peers. Provide real time accurate information to patient/family/caregiver for resources for which they are eligible. Provide condition-specific and related medical, financial, educational, and social supportive resource information. Identifies needs, develops programs, and evaluates outcomes for special populations, as needed, and implements changes based on outcomes. Facilitates collaboration with community agencies to enhance investigation and intervention process. Advocates for patient population on a systems level (hospital, organization, and/or community) by developing programs and protocols to better meet the needs of the patient population. Educating patient and family to recognize progress and assist in identifying need for changes in treatment plan.

Psychosocial Intervention- Provide psychosocial services as identified in the patient's comprehensive plan of care. Creates opportunities for and provides supportive counseling with the goal of maximizing emotional coping and adherence to the treatment plan. Facilitates and enhances collaboration with the referral source and appropriate members of the health care team in a timely and effective manner. Use expert knowledge and skill to educate the patient/family/caregiver and members of the health care team about evidenced-based treatment options. an expert in providing self-management support to high risk/complex patients/families to increase their skills and confidence to effectively manage their chronic care conditions at home. Identifies needs, develops programs, and evaluates outcomes for special populations as needed, and implements changes based on outcomes. Motivates and empowers patients/families/caregiver through the use of anticipatory guidance and planning to reduce or eliminate psychosocial barriers to discharge. Is seen as a leader in initiating and facilitating family centered care team meetings. Demonstrates a therapeutic approach focusing on micro and macro systems including assessment and crisis intervention with the goal of problem prevention.

Interdisciplinary Collaboration- Working for system improvement, promoting patient/family/caregiver well-being. Advocates for patient population on a system level (hospital, organization, and/or community) by developing programs and protocols to better meet the needs of the patient population. Is seen as a resource and initiates liaison role between the patient/family/caregiver within the medical team and outside agencies. An expert in mediating as needed within the medical team on behalf of the patient/family/caregiver. Empower the patient/family/caregiver to problem-solve by exploring options of care when available and alternative plans, when necessary, to achieve desired outcomes. Develops processes for effective and efficient communication and coordination between members of the health care team while involving the

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