Accreditation Standards, Chronic Disease, Chronic Renal Disease, Conferences, Crisis Intervention, Dialysis, Disease Treatment, Documentation, Driver's License, Establish Priorities, Health Plan, Healthcare, Home Care, Long-Term Care, Medicaid, Medicare, Nursing, Quality Assurance, Quality Management, Regulations, Social Work, Team Lead/Manager, Team Player, Time Management, Treatment Plan
Salary : $32-39/Hourly | Full-time | Watertown,SD
Prioritized Must Have Skills for the Social Worker:
#1. Master's Degree in Social Work (MSW) required.
#2. Licensed Social Worker in the State of South Dakota required.
#3. Valid South Dakota driver's license required.
Responsibilities of the Social Worker:
- Conduct comprehensive psychosocial assessments to evaluate emotional, behavioral, financial, environmental, and support-system factors that may impact treatment adherence and overall well being.
- Develop individualized care plans addressing complex psychosocial needs, including adjustment to chronic illness, coping strategies, and long-term care planning.
- Provide short-term counseling and crisis intervention for patients and families experiencing anxiety, depression, grief, trauma, or adjustment difficulties related to chronic kidney disease and dialysis treatment.
- Collaborate closely with nephrologists, physicians, nurses, dietitians, and other healthcare professionals to integrate psychosocial findings into the overall treatment plan.
- Facilitate patient and family conferences to enhance understanding of medical recommendations and promote adherence to dialysis and treatment protocols.
- Educate patients and families on available community resources, insurance benefits, disability programs, transportation services, advance directives, and financial assistance options.
- Assist patients in navigating Medicare/Medicaid, disability applications, transplant referrals, and other healthcare coverage matters.
- Coordinate transitions of care, including referrals to rehabilitation facilities, home health services, long-term care, transplant centers, or other appropriate levels of care.
- Advocate for patients within the healthcare system and community to ensure access to necessary services and removal of barriers to care.
- Facilitate and lead support groups focused on coping with chronic illness, treatment compliance, lifestyle adjustments, and emotional resilience.
- Provide crisis mediation in high-stress or emotionally complex situations involving patients, families, or care teams.
- Participate actively in interdisciplinary team meetings to review patient progress and adjust care plans accordingly.
- Maintain accurate, timely documentation of psychosocial assessments, interventions, care plans, and progress notes in accordance with regulatory and accreditation standards.
- Provide general direction and supervision to BS/BA-level social workers or support staff as assigned.
- Contribute to quality improvement initiatives by identifying social determinants of health impacting patient outcomes and recommending service enhancements.
- Perform additional duties as assigned to support the dialysis unit and organizational mission.
Requirements of the Social Worker:
- Master's Degree in Social Work (MSW) required
- 2 years of experience required
- Licensed Social Worker in the State of South Dakota required
- Valid South Dakota driver's license required