Care Coordinator (LCSW)

Spaulding Hospital - Boston and Cambridge
United States, Massachusetts, Lexington
1 Maguire Road (Show on map)
Jan 01, 2025
Work directly with pediatric patients (and their families) in the outpatient setting who are injured, ill, or newly diagnosed with a pediatric condition and who may experience altering changes in income, health insurance coverage, physical access to their home, specialized transportation, and caregiver assistance to maximize independent function in the community. Collaborate across the continuum of care and with the interdisciplinary inpatient and outpatient rehabilitation teams, community providers, and community agencies to promote the highest level of independent function and an active, productive and fulfilling life. Direct and assist patients and their families in the application process for federal, state, and private resources and provide access to specialized disability community resources. Key Responsibilities * Patient and family assessment is conducted per established guidelines. * An individualized longitudinal plan of care is developed in collaboration with the interdisciplinary team, patient, and family, and community providers to maximize quality and cost-effective outcomes while incorporating patient and family goals, expectations, and preferences. * Education is provided to the patient, family, and the interdisciplinary team regarding community resources and insurance benefits to support the most effective use of these resources to promote maximize and maintain independence. * Advocacy is provided to meet the comprehensive needs of the patient and family and to promote quality cost effective outcomes. * Assistance with income replacement, health insurance, transportation, and referrals to appropriate and available community resources is provided. * Communication and coordination is actively promoted between members of the interdisciplinary team, the payer and the community to minimize fragmentation of services and to maximize outcomes; patient centered team meetings are planned and conducted when indicated. * Assistance with problem-solving and availability as a resource to the outpatient clinicians is provided. * Culturally competent care is displayed to identify the patient's cultural needs and incorporate them in the development of the longitudinal plan of care. * Documentation is completed in adherence to department standards. * Additional department, organization, or network activities are completed per established objectives. PCC Organizational Values of Innovation, Collaboration, Accountability, Respect, and Excellence are upheld. Qualifications - External Qualifications and Experience Education/Degree Required Master's degree from an accredited school. Preferred Experience Required * Case management, utilization review, or discharge planning experience in an acute, rehabilitation, skilled nursing or outpatient setting is required. Preferred * 5 years of related pediatric experience is preferred * Certification in Case Management is preferred Licensure Required Current, unrestricted license to practice in Massachusetts in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice of the discipline. Examples are Nursing, Physical Therapy, Occupational Therapy, Speech/Language Pathology, LCSW, Respiratory Therapist or Rehabilitation Counselor. LCSW, or LICSW Preferred Skills(Specific learned activity gained through training (e.g. computer skills, keyboarding, presentation, CPR, ACLS,etc.) Required Knowledge of community services and the healthcare systems required Knowledge of criteria and levels of care is required Access to reliable transportation to travel to pediatric outpatient sites across the Spaulding Network as necessary Computer proficiency required. Microsoft office applications preferred with ability to learn new software. Knowledge of community services and the healthcare system is required. Preferred Highly developed communications and interpersonal skills, working with diverse population. Work independently, be self-directed and contribute as a member of a team. Anticipates challenges and develops and implements strategies for addressing them. High level of service delivery. Demonstrate initiative with ability to prioritize work, meet deadlines and adapt to changing situations. Attention to detail Bilingual EEO Statement SRN is committed to diversity in the workplace which begins with respect and opportunity for all. SRN takes affirmative action to ensure that equal employment opportunity is provided to all persons regardless of race, religious creed, color, national origin, sex, sexual orientation, gender identity, genetic information, age, ancestry, veteran status, disability or any other basis that would be inconsistent with any applicable ordinance or law. Additional Job Description The Spaulding Rehabilitation Hospital Corporation is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.