Social Worker - Advanced Illness Care

About This Role

The Social Worker delivers psychosocial evaluations, counseling, and casework services to patients with advanced illnesses, coordinating referrals and providing palliative care and bereavement support.

Responsibilities

• Conduct comprehensive psychosocial assessments and make appropriate referrals to community resources
• Collaborate with clinical and support staff regarding patient/family/caregiver issues
• Conduct patient and family counseling and education regarding community resources, benefits, and entitlements
• Help patients and families develop coping strategies for declining physical health and emotional/spiritual needs
• Partner with patient providers and interdisciplinary care teams to facilitate care aligned with individual needs
• Provide short-term crisis intervention and advocate for families
• Assist with management of transitions of care between various settings
• Provide direct patient care support in various settings, utilizing palliative care principles and trauma-informed care for advanced illness patients
• Participate as a member of the interdisciplinary care team to establish and implement psychosocial care plans
• Assist patients and families with advance care planning, including discussions about goals of care and documentation
• Communicate and coordinate with other providers to ensure care is consistent with patient's goals of care
• Assist with establishment of power-of-attorney for health care and end-of-life care plans
• Provide education to patients, families, caregivers, and staff on mental health issues, grief, and community resources
• Provide consultation on ethical issues that arise for staff
• Conduct mental status exams as requested by Providers

Requirements

• Master’s degree in social work from an accredited college
• Current Oregon LCSW, LMSW or CSWA license
• Minimum 1 year work experience in geriatrics, home health, hospice, hospital, primary care/specialty care clinic or other community based mental health or outreach social work
• Valid driver’s license, acceptable driving record, and automobile liability coverage or access to an insured vehicle
• CPR certification at hire or within 6 months in position

Qualifications

• Master’s degree in social work from an accredited college
• Minimum 1 year work experience in geriatrics, home health, hospice, hospital, primary care/specialty care clinic or other community based mental health or outreach social work

Nice to Have

• Experience dealing with substance use disorders, care coordination and needs assessment for high-risk populations

Skills

* Required skills

Benefits

Certifications