Social Worker, House Calls

DaVita Medical Group - Torrance, CA3.3

HealthCare Partners is seeking a social worker to support our house calls team focused on palliative care patients.

Candidates with hospice or palliative care experience are prefer.

Responsible for providing clinical social work services to individuals and families on an outpatient basis including counseling and crisis intervention, short-term case management, and information and referrals to community resources. Assists providers and Care Managers by acting as a consultant for patients with complex psychosocial needs.

Performs psychosocial evaluations of patient’s physical, social and emotional functioning as well as financial and family support as needed.
Develops a treatment plan or plan of care which includes arrangements for referral to services as appropriate.
Provides community resource information and performs referral and liaison activities as necessary for the patient’s ambulatory care.
Acts as a consultant to patients requiring information on Advanced Directives.
Participates as appropriate in weekly patient care rounds for patients in skilled nursing facilities.
Assists Care Managers with discharge planning for patients with complex discharge needs.
Participates in patient care rounds for patients in acute setting and collaborates with hospital Social Worker as needed (if appropriately licensed or with appropriate oversight).
Performs in-home psychosocial assessments to assist with patient and family social, financial and emotional needs.
Documents social work interventions by inclusion of reports in medical records and referral management system as needed.
Maintains statistical data on social work treatment plan, intervention and outcomes.
Participates on an assigned basis in educational training for employees and providers related to the psychosocial aspects of physical and emotional illness/disability.
Acts as a resource to other Social Workers within the organization on difficult to manage cases.
Maintains current information on all frequently used community resources, financial resources and placement facilities. Routinely updates resource list and is available to discuss how to resource required services.
Identifies and intervenes with high-risk patients requiring social services through all ambulatory case management programs.
Uses, protects, and discloses HCP patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
Performs additional duties as assigned.

Bachelor’s degree from a four-year college and/or a professional certification requiring formal education beyond a two-year college.
Bachelor’s degree in Social Work or Master’s degree in a related field.
MSW or LCSW preferred.

Over 1 year and up to and including 3 years of experience.
Managed care experience.

3 years of experience in a hospital or other healthcare setting.

Computer literate.
Proficiency in Microsoft office applications (Word, Excel).
Ability to type 25 wpm.
Knowledge of community resources.
Excellent assessment skills.
Ability to exercise objectivity and good judgment relating to difficult and emotionally-charged situations.
Excellent verbal and written communication skills.
Ability to interface effectively with patients, providers, management and employees of the organizations as well as facilities and agencies in the community.