Community Outreach Social Worker

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.

Exempt

The Outreach Social Worker is responsible for providing comprehensive social services which assist patients, clients and their families to find practical ways of overcoming social, emotional and environmental barriers to optimum functioning and attainment of health. The Community Outreach Social Worker alters activities/behaviors to reflect and ensure adequate care and services appropriate to the age of patients served (i.e. neonatal, infant, pediatric, pre-school, school age, adolescent, adult and geriatric).

• Interviews patients and their families in an outpatient and community setting to identify and address social needs.
• Responsible for managing assignment of patients referred by the intensive care manager, ensuring that 100% of patients with an identified need have been assessed and evaluated.
• Build rapport with patients and their families and relay medical concerns needing addressed to the intensive care manager.
• Initiates social service plans for patients/clients through professional collaboration with intensive care managers, primary care providers and health care personnel utilizing screening questionnaires, diagnostic assessments and individualized therapeutic care plans.
• Assess patient's needs, situation, strengths, and support networks to determine their goals.
• Serves as a liaison between patient/family and healthcare personnel to ensure necessary care is provided promptly and effectively.
• Assists patients and families in understanding the implications and complexities of their medical situation and its impact on their current lifestyle.
• Advocates on behalf of vulnerable patients and participates in assessing and evaluating their need for health care services and community programs; and assists them with getting connected to those services.
• Provides direction in the selection, analysis, summarization and presentation of patient/client and related information for service delivery planning, case conferences and professional consultation.
• Provides complex social service intervention to individuals, families and groups ranging from diagnostic assessment, short term counseling, crisis intervention, community resource referrals, client advocacy, support, outreach, follow-up and intra/inter agency consultations.
• Educate and inform patients of community resources that are located within their neighborhood community.
• Provides education and training to introduce or improve coping skills of individuals and families.
• Document services rendered in the medical record.
• Conducts social service orientation for physicians, community health workers, nurses, and students as appropriate.
• Utilizes problem-solving skills to identify and facilitate problem resolution in team functioning.
• Participates in staff meetings and education programs for staff and community agencies as assigned.
• Assumes responsibility for continuous professional self-development.
• Alters activities/behaviors to reflect/ensure adequate care appropriate to the age of patients served (i.e. adolescent, geriatric, pediatric, neo-natal, adult) described in the area/unit age-specific and/or job specific competencies.
• Collaborates with multi-disciplinary team members to facilitate the coordination and delivery of services that assures appropriate treatment plans and continuity of care.
• Initiates advocacy/liaison role for patients/clients in referrals to and from community agencies: collaborates with agency and hospital personnel in referral activities: cultivates referral resources.
• Interprets impact on client functioning of environmental conditions and family interactions through home visits and outpatient encounters.

• Minimum of a Master of Social Work with at least 2 years of experience in a similar environment or Active licensure as a Social Worker (LSW) or Clinical Social Worker (LCSW).
• Social service experience in a healthcare setting dealing with pediatric, adolescent, adult and geriatric patients is preferred.

• Knowledge and skills necessary to provide care appropriate to the age of patients served. Must demonstrate knowledge of growth and development principles over the life span and possess the ability to assess data/interpret appropriate information needed to identify each patient's requirements relative to age-specific needs. Ability to use age appropriate communication and skills detailed in the department/area/unit job specific/age specific competencies.
• Analytical, psychosocial assessment and counseling skills.
• Knowledge of pertinent State/Federal laws and regulations, community…