As a member of the multidisciplinary care team, the Social Worker provides assessment, counseling, discharge planning, financial assistance coordination, and related support to patients and families. This role ensures that services are aligned with the needs and interests of swing bed patients, promotes self-care, encourages the resumption of normal activities, and supports optimal psychological functioning.
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Complete all required documentation for the Social Services Department.
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Assess new potential residents in collaboration with the Director of Nursing.
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Perform clerical duties as needed.
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Attend required trainings and seminars.
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Prepare and submit monthly Quality Assurance (QA) reports.
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Conduct comprehensive assessments through interviews with patients, families, and relevant parties.
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Gather and evaluate social histories.
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Develop individualized care plans based on identified needs.
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Participate in:
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Case management
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Discharge planning
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Care plan conferences
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Family conferences
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Document all relevant findings and interventions in patient charts.
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Provide individual and family counseling.
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Offer guidance on:
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Advance Directives
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Interpersonal relationships
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Stressful life events
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Chronic and terminal illnesses
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Substance abuse issues
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Life transitions and treatment adjustments
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Assist patients and families in navigating healthcare-related financial matters, including:
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Insurance coverage and benefits
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Applications for assistance (Medicaid, workers’ compensation, etc.)
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Connect patients with community resources such as:
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Emergency housing
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Food and clothing assistance
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Transportation services
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Educational/tutoring services
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Coordinate payment plans and assist with legal or financial arrangements when necessary.
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Coordinate safe and effective discharge plans, including:
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Transportation arrangements
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Meals on Wheels services
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Home health referrals
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Durable medical equipment
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Placement in skilled nursing or long-term care facilities
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Transfers to other healthcare facilities
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Housing and employment resources
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Maintain accurate patient records and statistics.
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Prepare:
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Social histories and updates
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Discharge plans
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Progress notes
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Provide reports for case management and external agencies.
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Provide education on:
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Advance Directives (including completion assistance)
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Abuse, Neglect, and Exploitation reporting
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Patient Portal usage
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Develop and update policies and procedures in compliance with hospital, state, and federal regulations.
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Engage in community outreach through:
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Newsletters
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Newspaper articles
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Community events
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Serve as a liaison with auxiliary and community groups to promote facility awareness.
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Knowledge of medical terminology and healthcare procedures.
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Strong written and verbal communication skills.
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Ability to prioritize workload and meet deadlines.
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Familiarity with community resources and social service programs.
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Basic to intermediate computer proficiency.
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Working knowledge of Windows-based systems.
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Ability to use:
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Email
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Word processing
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Spreadsheets
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Presentation software
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Ability to organize and communicate information effectively using digital tools.
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Support the organization’s mission and vision.
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Maintain strict confidentiality.
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Work effectively within a team environment.
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Demonstrate compassion, respect, and professionalism.
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Exhibit flexibility and a positive attitude.
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Identify problems and contribute to solutions.
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Independently determines appropriate social service interventions.
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Collaborates with physicians, nursing staff, and allied health professionals.
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Consults leadership (COO, CNO) and care team members for complex cases.
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Supporting terminally ill, aging, or permanently disabled patients.
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Managing crisis situations.
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Staying current with frequently changing social and government programs.
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Assisting patients who do not qualify for traditional resources.
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Maintaining professionalism and empathy in difficult situations.
This role may include other duties as assigned based on organizational needs. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
This position is an on‑site role and is not eligible for remote or telecommuting work. Regular, in‑person attendance at the designated work location is an essential function of the position.
This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the position. Duties and responsibilities may change or be added as business needs require.
To perform this position successfully, the individual must be able to perform each essential function satisfactorily. The qualifications listed below represent the knowledge, skills, and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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Bachelor’s degree in Social Work (BSW) or a related field required.
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Demonstrated knowledge of social work principles, practices, techniques, and human behavior.
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Experience working with complex psychosocial issues in a healthcare or similar setting.
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Experience providing services to individuals and groups, including counseling and intervention strategies.
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Ability to apply social work principles effectively within a medical environment.
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Must meet all requirements of the Kansas Behavioral Sciences Regulatory Board (BSRB) for Social Work practice.
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Must hold a current, active Social Worker license in the state of Kansas.
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Required certifications:
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CARE Assessor certification
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SHICK (Senior Health Insurance Counseling for Kansas) certification
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Must meet all applicable state certification requirements, including those related to Activity Programs (as applicable).
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Ability to understand and carry out detailed written and verbal instructions.
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Strong problem-solving skills, including the ability to:
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Define problems
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Gather and evaluate information
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Establish facts
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Draw logical and valid conclusions
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Ability to manage standardized processes while adapting to patient-specific needs.
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Demonstrates a friendly, approachable, and helpful demeanor.
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Maintains professionalism at all times in a service-oriented healthcare environment.
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Effectively interacts with diverse populations, recognizing that all patients, families, and staff are valued customers.
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Subject to frequent interruptions and changing priorities.
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Regular interaction with individuals exhibiting a wide range of personalities and behaviors.
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Potential exposure to:
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Medical equipment
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Chemical substances common in healthcare settings
The physical demands listed below are representative of those required to successfully perform essential job functions. Reasonable accommodations may be made where appropriate.
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Occasional lifting and carrying of up to 50 pounds.
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Periods of prolonged standing and walking.
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Frequent physical movements, including:
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Reaching
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Stooping
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Bending
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Kneeling
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Crouching
