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PURPOSE
AND
SCOPE : Provides
psychosocial services to patients treated by the facility including
in-center and home dialysis patients (if applicable) utilizing
Social Work Theory of Human Behavior and accepted methods of social
work practice. Works with the health care team to promote positive
adjustment, rehabilitation and improved quality of life for our
patients. In collaboration with the interdisciplinary team,
informs, educates and supports staff in understanding the
emotional, psychological and behavioral impact of Chronic Kidney
Disease on the patient and family to ensure comprehensive quality
care of our patients. Supports the FMCNA commitment to the Quality
Indicators and Outcomes and Quality Assessment and Improvement
(QAI) Activities, including those related to patient satisfaction
and quality of life and actively participates in process
improvement activities that enhance the likelihood that patients
will achieve the FMCNA Quality Goals. This is an entry level MSW
role.
PRINCIPAL
DUTIES AND
RESPONSIBILITIES : Patient
Assessment / Care Planning /
Counseling
As a member
of the interdisciplinary team, assesses patients' psychosocial
status, strengths and areas of need that may affect rehabilitation
and optimal treatment outcomes as part of the comprehensive patient
assessment.
Participates in care
planning in collaboration with the patient and healthcare team to
identify effective interventions that will help the patient meet
rehabilitation, treatment goals, and improve quality of
life.
Utilizes FKC
patient education programs, established social work theory and
methods, social work focused interventions, and quality of life
measurement instruments as part of assessment and care planning to
address barriers and meet patient treatment
goals.
Provide monitoring and
interventions for the patient to adjust to dialysis and achieve
optimal psychosocial status and quality of
life
Provide supportive counseling services to
patients as permitted within the scope of their clinical training
and state license
Provides
educational and goal directed counseling to patients who are
seeking
transplant.
Provides
information and assists the team and patient with referral to
community resources (home health services, vocational
rehabilitation, etc.) to facilitate optimal treatment
outcomes.
Maintains
current knowledge regarding local vocational / educational
rehabilitation programs and assist patients with referral and
access to vocational rehabilitation to enable them to remain
employed, become employed or receive education.
Assesses patient
awareness of advance directives; assists with accessing advance
directive forms / information and facilitates discussion of advance
directive wishes, if necessary, with the healthcare team and the
patient's family / support
persons.
In
collaboration with the physician and nurse, participates in the
discussion of patient DNR status in the facility to ensure patient
and / or family understand and make an informed decision about their
care.
Knowledgeable of
and adheres to FMCNA Social Work Policy and Measuring Patient
Physical and Mental Function Policy, including
documentation.
Documents
based on MSW interaction and interventions provided to patient
and / or family.
Quality
Provides
psychosocial support and / or Social Work Focused Interventions to
address non-adherence, quality outcome, and quality of life
concerns for all patients based on acuity
level.
Participates in
monthly Quality review meetings with the interdisciplinary team.
Reports on quality indicators related to adherence, such as Missed
and Shortened Treatments, Quality of Life Trends, and Service
Recovery.
Patient
Education
Assesses
patient knowledge of kidney disease for barriers that may affect
adherence to treatment. Works with patient, family and health care
team to provide education tailored to the patient’s learning style,
communication barriers, and
needs.
With other
members of the interdisciplinary team, provides appropriate
information about all treatment
modalities.
Facilitates
the transplant referral process and collaborates with
interdisciplinary team on transplant waitlist
management.
Provides
ongoing education to patient / family regarding psychosocial issues
related to End Stage Renal Disease (ESRD) and all support services
that are available.
Reviews patient
rights and responsibilities, grievance information (company and
network) and other facilities policies with patient and / or the
patients’ representative to ensure patients’ understanding of the
rights and expectations of
them.
Collaborates
with the team on appropriate QAI
activities.
Patient
Admission and Continuity of
Care
Review Patient
Rights and Responsibilities, Grievance Procedure & Important
Numbers Handout, FKC Non-discrimination policy, DNR Statement (if
applicable) and address any immediate
needs / concerns
Understands
the referral and admission process and supports the clinic in
regard to the patient needs for scheduling to maximize adherence
and adjustment
The Social Worker
will interview the patient to identify root causes or concerns for
the discharge request, (i.e. transfer to hospice, relocation,
dissatisfaction with services or staff) and share causes / concerns
with operational
leadership
Insurance
and Financial
Assistance
Collaborates
and functions as a liaison for patient with Insurance Coordinators
to address issues related to insurance.
In collaboration with
Insurance Coordinators, provides information and education to
patients about payment to dialysis (federal, state, commercial
insurance, state renal programs, AKF HIPP, and entitlement
programs)
Collaborate
with the Insurance Coordinator of any changes to patient state that
impacts insurance i.e. transplantation, discharged, loss of
coverage, or extended
travel.
Refer patients
to patient billing solutions (PBS) department for
questions / concerns in regard to treatment related
bills
Staff
Related
Assists with
interview process and decision to hire new personnel if requested
by SW Manager / Senior Manager.
Works with the
administrative support staff to maintain updated patient resource
lists (e.g. maintain updated list of transportation resources).
Provides training to
staff pertaining to psychosocial topics as needed.
Contributes and
participates with weekly team huddles. Discusses any urgent patient
issues with staff.
Adheres
to work defined caseload guidelines based on state regulatory
requirements.
In
states where required works under appropriate supervision to meet
state requirements.
Performs other
related duties as
assigned.
PHYSICAL
DEMANDS AND WORKING
CONDITIONS : The
physical demands and work environment characteristics described
here are representative of those an employee encounters while
performing the essential functions of this job. Reasonable
accommodations may be made to enable individuals with disabilities
to perform the essential functions.
Travel
required (if multiple
facilities)
SUPERVISION :EDUCATION
AND REQUIRED
CREDENTIALS : Masters
in Social Work
Must
have state temporary license, Registered Social Worker Clinical
Intern, Associated Social Work license or Provisional LCSW License
(if required by
state)
Obtains
necessary state licensure to work independently without supervision
within the first two (2) years or as required by state guidelines.
EXPERIENCE
AND SKILLS : – 2 years’ related
experience
The
rate of pay for this position will depend on the successful
candidate’s work location and qualifications, including relevant
education, work experience, skills, and competencies.
/ >
Annual Rate : $71000 - $96000
/ >
Non-Bonus Eligible Positions : include language below.
/ >
Benefit Overview : This position offers a comprehensive
benefits package including medical, dental, and vision insurance, a
401(k) with company match, paid time off, parental leave.
/ >
Bonus Eligible Positions – include language
below.
Benefit Overview : This position offers a
comprehensive benefits package including medical, dental, and
vision insurance, a 401(k) with company match, paid time off,
parental leave and potential for performance-based bonuses
depending on company and individual
performance.
EOE,
disability / veterans
Social Worker • Stockton, CA, US