UnityPoint Health
Location
Waterloo, Iowa
Coordinate interdisciplinary care plans for mental and behavioral health patients to ensure effective treatment and prompt care. Manage the discharge process by coordinating referrals, pharmacy services, and follow-up care to address social determinants of health.
A Bachelor of Social Work (BSW) degree is required for this position. One year of clinical experience in a healthcare setting is preferred.
Keep patient family or others informed as to the patient’s progress throughout treatment as the patient desires. Complete and update safety plan Lead psychoeducational groups – some regions don’t but it would be within their scope, if they have BPD might suggest a steps group, not leading formal education Maintain timely and accurate documentation participates in multi-disciplinary team May develop and maintain the patient’s treatment plan throughout the patient’s course of treatment with input from the care team May assist in patient rounding Primary responsibility for coordinating care to facilitate discharge Make necessary referrals Provide patient education relating to post-acute levels of care/services Assure patient’s SDOH needs are met for an effective discharge plan Coordinate pharmacy and outpatient services follow up Assure that patient has a 7 day follow up post discharge Align transportation and follow up with natural supports on behalf of the patient Participate in all required trainings and educational activities Participate in department level meetings and huddles Be responsive to email, phone messages and patient portal messages
Education: Bachelor’s degree in Social Work required Experience: One year of clinical experience in health care preferred Other: Knowledge of the social work process Awareness and sensitivity to cultural diversity Knowledge of the physiological elements of illness and impact on psychosocial functioning Knowledge of the healthcare system and resources available to patients. Strong interpersonal skills and ability to work as a collaborative team member Knowledge of social determinants of Health Strong verbal and written communication skills
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