Social Worker Care Coordinator - Behavioral Health Home
Full Time
Hibbing, MN 55746
Posted
Job description
Overview:
As a key member of the Primary Care Behavioral Health Home (BHH) team, the Social Work Care Coordinator (SWCC) supports health and wellness for patients with chronic mental and physical health conditions. In collaboration with the BHH team, the SWCC supports the care transition and coordination needs of the defined patient population. The SWCC works closely with patients/families, the care team, and community services to address patient healthcare and resource needs. A combination of face to face and telephonic services will be provided to BHH eligible / enrolled patients to meet the triple aim.
Responsibilities/Job Description:
- Assesses patient situation and identifies patient care and discharge needs.
- Develops and facilitates timely individualized patient care and discharge plans.
- Provides a range of generalist social work interventions to assist patients and families reach their goals.
- Works with other interdisciplinary team members to assess patient's functional capacity, need for community services or placement to meet identified care needs.
- Advocates for individual patients, families and patient groups from social work theory and practice perspectives.
- Facilitates case management, crisis intervention, problem solving, supportive counseling, group work, psychoeducation, information and referral services, and abuse reporting as appropriate.
- Responsible for assisting the patient in setting up and preparing for appointments, and following up with the patient.
- Responsible for developing and nurturing relationships with other community and social support providers to aid in effective referrals and timely access to services.
Required:
- Bachelors Degree in Social Work
- Current Minnesota Social Work Licensure (LSW)
- Basic Life Support (BLS)
Preferred:
- One year medical or Mental Health Social Work experience
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