Overview:
Provides direct social work services in collaboration with the program leadership and the team consistent with VNS Health Behavioral Health policy. Conducts assessments and develops client/member centered plans of care. Provides coordination of services between the varying providers for clients / members with complex psychiatric, substance use, and/or co-morbid medical conditions. Ensures access and linkage to the full array of necessary physical and behavioral health services and other community based services to address social determinants of health. Coordinates effective communication between all providers for the ultimate benefit of the client/member. Works under general direction.
Responsibilities:
• Utilizes approved assessment tools to conduct a comprehensive clinical assessment that identifies clients’ needs.
• Creates initial plan of care based on comprehensive assessment, clearly identifying client goals. Updates plan at specified intervals, and as needed based on changes in client’s condition or circumstances.
• Performs and maintains effective care management for assigned caseload of clients/members. Tracks and monitors progress; maintains detailed, accurate and timely progress notes and other documentation.
• Works collaboratively with team members to provide outreach for and engage resistant/hard to reach clients/members to accept program services.
• Provides linkage, coordination with, referral to and follow-up with additional service providers. Arranges transportation and/or accompanies clients to entitlement appointments to ensure connection to care. Facilitates periodic case record reviews and case conferences with all providers serving the clients.
• Provides advocacy and assistance in obtaining entitlements and community services to clients, families and other caregivers. Arranges transportation and/or accompanies clients to entitlement appointments as necessary.
• Participates in initial and ongoing trainings as necessary to maintain and enhance clinical skills.
• Maintains updated case records in program EMR. Maintains case records in accordance with program policies/procedures, VNS Health standards and regulatory requirements.
• Participates and consults with program leadership in case conferences, staff meetings, and discharge planning.
• Participates in special projects and performs other duties as assigned.
Qualifications:
Education:
Bachelor's Degree in Social Work or a related human services field required
Work Experience:
Minimum one year of social work experience in a mental health or social service setting required
SUD Program: Minimum of two (2) years of experience supporting individuals with complex substance use conditions, with demonstrated expertise such as: crisis management; inpatient-to-community care transitions; and/or coordination of multidisciplinary and community-based services. required
Pay Range:
USD $25.46 - USD $31.86 /Hr.