Trinity Health Social Worker Care Coordination in Darby, Pennsylvania

In collaboration with Care Coordination staff, this position is directly involved in the process of assessment, planning, facilitation, and advocacy for options and services to meet individual patient’s health care needs. Through communication and identification of available resources, participates in the promotion of quality outcomes, patient satisfaction, and cost-effective care delivery. This position reports to the Manager of Care Coordination.

  • Interviews patients/significant others within one working day of Utilization Management Nurse, ED Case Manager, Care Transition Nurse, or other referral to obtain data on personal, social, medical, emotional, cultural, and religious history in order to delineate problems requiring Social Work intervention and to plan appropriate services.
  • Collaborates with the Care Coordination staff and multidisciplinary team members regarding discharge planning and arranges for needed care in the home or an alternate setting.
  • Provides support and counseling to patients/families experiencing and/or anticipating issues to adjusting to illness, catastrophic diagnoses, changes in living situations and bereavement. Establishes a plan. Documents interventions and outcomes as required in the electronic record.

  • Consults, assesses, refers, coordinates interventions in cases of suspected or actual situations of child or abuse and neglect or other forms of domestic violence and/or sexual abuse.

  • Completes appropriate assessments for assigned patients to identify gaps in care, develop goals, and facilitate interventions and resources.

  • Assists patients/families to complete applications for Medicaid benefits.

  • Manages the placement process into long term care facilities. Reviews financial resources for long term placement and provides education to the patient/family.

  • Other duties as assigned

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Job Number: 00093779

Location: Darby, PA

Organization Name: Mercy Health System of Southeastern Pennsylvania

Facility: MSEPA - Mercy Fitzgerald Hospital

Employment Type: Part time

Shift: Shift_9

Hours: 0