Ambulatory Social Worker Case Manager
Harvard University Health Services
Cambridge, Massachusetts 02138

Job Description

Assists HUHS patients and their families in coordinating medical, social, emotional, insurance, and vocational issues related to injury or illness. Conducts psychosocial assessments, either in-person or telephonically, in order to develop a comprehensive out-patient care plan that guides work with patient. Collaborates with physicians, nurses, support staff, community agencies, and other health care professionals to implement safe, effective, and timely patient care. Communicates with treating clinicians on areas of concerns and provides clinical updates to clinicians on a regular basis. Provides timely and appropriate documentation in patient's electronic medical record. Participates in assuring that HUHS is in the forefront of applying Case Management principles. Participates in achieving the goal of cost effective, high quality, continuous care to patients; communicates effectively with clinicians, patients, and team leader to achieve this goal. Utilizes team leader as appropriate for clinical consultation and to apprise of legal, ethical, risk issues that may affect the patient, family, or health services. Maintains quality assurance and improvement activities in compliance with HUHS standards. Assists in development of reports and resources required by other departments.

Position Description:
Assumes responsibilities of an active caseload, including following patients throughout the continuum of care.
Provides Ambulatory Case Management services to identified HUHS patients through a process of research, patient interview, development of care plans and monitoring of care.
Researches clinical history of identified patients using all necessary and appropriate resources.
Provides a clinical assessment either telephonically or as appropriate in person to assess patient's needs and perception of their health status.
Provides pre-operative outreach and assessment to identified student athletes.
Assists HUHS patients and their families coordinate medical, social, emotional, insurance, and vocational issues related to injury or illness.
Educates patients and families regarding Advance Directives and assists patients and families in completing Advance Directives.
Promotes effective communication with hospitals and their departments. Educates them to resources available at Harvard University Health Services.
Participates in/attends IM Team Meetings and daily huddles.
Participates in/attends HUHS committees/work groups when appropriate.
Communicates with primary care clinician, patient, and home care provider to ensure medically necessary services. Regularly communicates with patients requiring post- discharge service to assess patient satisfaction and that appropriate services are in place.
Evaluates utilization and effectiveness of Home Care provider network.
Assess quality of care of Home Care providers as well as responsiveness. Addresses areas of concerns with manager to ensure optimal quality of care for patients.
Educates patients/families about non-skilled services for patients when necessary. Assists in arranging for these services when patients/families allow.
Actively participates in project development. Collaborates with manager to implement, evaluate, and support programs to maximize utilization of available resources.
Assists in maintaining a Quick Reference Resource Guide.
Educates patients/families/caregivers as to trajectory of certain disease processes and level of support/care needed throughout disease process.
Educates patients/families about health insurance processes and when appropriate benefits. Directs patients/families where to learn more about health insurance benefits.
Collaborates when appropriate with BCBS MA Nurse Case Manager in case management of HUSHP/HUGHP patients with complex medical and psychosocial needs.
Develops a comprehensive treatment plan. Monitors and assesses appropriateness of treatment plan and makes appropriate modifications as necessary.
Communicates with PCP or treating clinician on areas of concern in addition to ongoing updates on clinical progress.
Reports incidences of suspected abuse and neglect of children, elders, and individuals with disabilities to appropriate designated state agency.
Organizes and participates in patient case conferences as needed Provides timely, appropriate, comprehensive clinical documentation in patient's electronic medical record.
Provides cross coverage for co-workers as needed.
Identifies own learning needs and requests assistance from others when needed.
Works independently, as well as collaboratively, with all members of the health care team.
Treats patients with dignity, respect, and compassion.
Provides prompt care/service and behaves sensitively in all interactions.
Deals with others in a sensitive, tactful, positive, and courteous manner.
Accepts and acts upon feedback.
Utilizes team leader as appropriate for clinical consultation and to apprise of legal, ethical, risk issues that may affect the patient, family, or health services.


Additional Information:
The University requires all Harvard community members to be fully vaccinated against COVID-19 and remain up to date with COVID-19 vaccine boosters, as detailed in Harvard's Vaccine & Booster Requirements. Individuals may claim exemption from the vaccine requirement for medical or religious reasons. More information regarding the University's COVID vaccination requirement, exemptions, and verification of vaccination status may be found at the University's "COVID-19 Vaccine Information” webpage: http://www.harvard.edu/coronavirus/covid-19-vaccine-information/.

Commitment to Equity, Diversity, Inclusion, and Belonging:
Harvard University views equity, diversity, inclusion, and belonging as the pathway to achieving inclusive excellence and fostering a campus culture where everyone can thrive. We strive to create a community that draws upon the widest possible pool of talent to unify excellence and diversity while fully embracing individuals from varied backgrounds, cultures, races, identities, life experiences, perspectives, beliefs, and values.

Basic Qualifications:
Masters in social work
Current license to practice social work in Massachusetts, either LCSW or LICSW
Minimum of 2 years of social work experience in medical setting

Certificates and Licenses:
Masters in social work
Current license to practice social work in Massachusetts, either LCSW or LICSW

Working Conditions:
This position is not remote, it is an in office position.

Apply Here

PI185452642


Preferred Years Of Experience:

2 Year(s)

Education Required:

Masters Degree - MA

Employment/Position Type:

Part Time
Date Posted : 07/26/2022