Lead Licensed Clinical Social Worker - Transitional Care, Full-time, Days

Company Description

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

Job Description

Northwestern Medicine has an exciting opportunity for a LCSW to work as a Lead in our outpatient Transitional Care clinic. 

Transitional Care is a primary care physician’s office that assists patients with follow-up care after being seen in the emergency department or inpatient at NM. We are a short-term clinic and utilize a collaborative model when working with our patients. We provide assistance with psychosocial needs as well as medical needs. We help stabilize patients medically and provide them with any resources they may need. We teach them how to navigate the medical system and then “launch” them to a long-term PCP in the community.  

The Clinical Lead Social Worker will work with complex patients who present to the clinic. This includes providing emotional support, case management needs, and/or addressing any barriers to care they may have. This role also helps to manage a group of 6 health advocates. This role will also assist with admin work or project-based work. This role is included in Transitional Care Clinic leadership and is responsible for mentoring & chart reviewing each health advocate.

Schedule: M-F, days; no nights/weekends/holidays/on-call

The Social Work Clinical Leader reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards.

Responsibilities:

• Performs all functions of a Licensed Clinical Social Worker (LCSW); see job code 2027.
• Facilitates Service line, HUB, or outpatient Social Work operations according to policy, procedure, and regulatory requirements.
• Coordinates Service line, HUB, or outpatient staffing assignments on to achieve high quality and cost effective care.
• Coordinates workflow as necessary.
• Participates in interviewing.
• Participates in Transition into Practice through managing new hire assignments and mentoring.
• Provides clinical direction and guidance to staff to ensure standards of high quality are achieved and maintained in the delivery of patient care.
• Responds as a leader to urgent issues such as disaster alerts and emergencies appropriately and in a timely manner.
• Champions new initiatives and leads Service line, HUB, or Outpatient committees/task forces.
• Implements specialized clinical procedures within Service line, HUB, and outpatient clinics involving complex factors unique to those areas/populations/diagnoses.
• Provides advanced clinical consultation to social work staff, other disciplines and trainees.

Additional Functions:

• Clinical:
  • Meets directly with patient/family to perform a comprehensive assessment including social, emotional, cultural, mental status, environmental and financial circumstances in conjunction with interdisciplinary assessment of the patient.
  • Recommends a plan of intervention based on mutually established goals.
  • Performs assessments of the physical environment and adequacy of support systems for outpatients to prevent a crisis and/or hospitalization.
  • Serves as the point person for the plan of care as it applies to discharge planning needs through facilitation of direct and continuous communication and collaborative decision making, including participation in multidisciplinary rounds and case conferences and other collaborative forums.
  • Coordinates action plans when barriers are present to facilitate resolution.
  • Proactively identifies and resolves delays and obstacles to discharge.
  • Utilizes advanced conflict resolution skills as necessary to ensure timely resolution of issues and system problems.
  • Seeks consultation from and makes referrals to appropriate disciplines/departments as required to expedite discharges.
  • Demonstrates expertise of community resources and an ability to connect patients and families with these resources.
  • Acts as an advocate on behalf of the patient who requires assistance to gain access to needed information, resources, or services.
  • Facilitates review of high risk cases by Office of General Counsel, Risk Management and informs