Hospice Travel Social Worker

Location: Identified Agrace new market areas

Full Time .8 FTE (32 hours/week) | Day Shift | Monday-Friday | 8am-5pm

Includes shared on call responsibilities

Includes 20% travel premium and paid travel expenses

Make a lasting impact with Agrace

Join Agrace, a nationally recognized nonprofit leader in hospice and palliative care. If you are a skilled Social Worker who values meaningful, patient-centered care, this is your opportunity to make a difference!

How You’ll Make a Difference (Essential Functions)

Travel Resource SW is responsible for patient and family satisfaction through the provision of direct social work services by conducting assessments, providing interventions, creating and updating the plan of care, communicating, and documenting. The Travel Resource SW is fulfilling temporary social work assignments throughout new hospice markets, as well as within currently established homecare teams when a need arises (vacancies, FMLA, high census). The Travel Resource SW provides patient and family centered care consistent with Agrace philosophy, goals, standards, regulations and policies.

Key Responsibilities

• Provide customer service to patients and families and assist with enrollment

  • Travel within the Agrace geographic service area to meet with patients and families.

  • Lead conversations with patients and families to convert appropriate referrals to admissions.

  • Answer questions about Agrace values, services, benefits and philosophies. 

  • Overcome objections to enrolling in hospice or palliative care and create a sense of urgency with each referral.

  • Obtain informed consent for hospice services and complete Electronic Health Records (EHR) documentation. Complete insurance paperwork, DME orders, pharmacy service enrollment, etc.

  • Provide required documentation and referral process information to healthcare facility partners, Health Information Management (HIM) Department and homecare team or inpatient unit.

  • Provide essential healthcare coverage and financial information to the Finance Department.

  • Collaborate with discharge planners and hospital staff to ensure ease of transition from hospital.

  • Assist with incoming referrals to Agrace services 

  • Facilitate follow-up and flow of information and legal documentation to admissions team and partners to support enrollment with Agrace.

  • Schedule Agrace enrollments and consults. 

  • Provide scheduled and unscheduled informational visits and tours to potential patients and families.

  • Collaborate with other members of the Admissions team and other teams to ensure smooth transition from referral to admission and thereafter.

  • Assist in training and providing shadow opportunities for internal and external partners when assigned

• Initial and Ongoing Patient/Family Assessments

  • Assess patient and family psychosocial, spiritual, grief and educational needs as part of the initial and comprehensive as per the patient’s individualized Plan of Care (POC).

  • Advocate for patient/family goals.

  • Coordinate transition planning in collaboration with the patient/family, homecare, and Interdisciplinary Team (IDT).

  • Anticipate and respond to patient/family psychosocial, spiritual, resource, or grief needs. Round on patients. 

• Care Planning and Coordination

  • Collaborate with IDT and patient/family to formulate, implement, and revise individualized Plan of Care 

  • (POC) in the electronic health record (EH