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POSITION SUMMARY

The Social Worker provides psychosocial assessment, counseling, support, resource coordination, and care planning services to patients and families served by the HomeCare and Hospice programs. The Social Worker participates as a member of the interdisciplinary team and provides services in accordance with applicable CMS Conditions of Participation, Michigan social work licensure and title requirements, and organizational policies. The Social Worker completes comprehensive psychosocial assessments, identifies patient and caregiver needs, develops and updates appropriate plans of care, provides counseling and supportive services, assists with community resource coordination, and collaborates with the interdisciplinary team to address psychosocial, emotional, financial, caregiver, and environmental concerns. The Social Worker also provides oversight and coordination of the Hospice Bereavement and Volunteer Programs, ensuring services are organized, appropriately documented, and provided in accordance with regulatory and organizational requirements. The Social Worker collaborates with the Social Services Assistant (SSA), who provides administrative and non-clinical program support for social work, bereavement, and volunteer services. An LMSW is preferred. A BSW-prepared social worker or LLMSW may be considered when appropriately licensed and working within the individual's permitted scope of practice. When required, clinical oversight and supervision will be provided by the agency's fully licensed LMSW in accordance with Michigan requirements and organizational policy. This position involves routine in-home patient and family visits within the HomeCare and Hospice service area, as well as documentation, interdisciplinary collaboration, and program coordination.

DUTIES & RESPONSIBILITIES

Clinical Social Work Services Conduct comprehensive psychosocial assessments for HomeCare and Hospice patients and families. Identify psychosocial, emotional, financial, environmental, caregiver, and resource needs affecting patient and family well-being. Develop, implement, and update social work interventions and goals in collaboration with the patient, family, and interdisciplinary team. Provide individual and family counseling, emotional support, crisis intervention, and supportive services appropriate to the patient's and family's needs. Assist patients and families with identification and coordination of community resources, financial assistance, advance care planning resources, and other appropriate services. Provide support and consultation related to caregiver stress, family dynamics, adjustment to illness, end-of-life concerns, and other psychosocial needs. Complete timely and accurate documentation in the electronic health record in accordance with regulatory and organizational requirements. Collaborate with the Social Services Assistant (SSA) regarding administrative and non-clinical support needs, including scheduling, routine bereavement mailings and follow-up, volunteer coordination, and other program-related tasks. Interdisciplinary Team Participation Participate in HomeCare and Hospice interdisciplinary team meetings and care planning. Collaborate with nursing, therapy, spiritual care, medical providers, and other members of the interdisciplinary team to support comprehensive, patient-centered care. Communicate significant psychosocial changes, risks, and concerns to the appropriate members of the care team. Provide recommendations regarding psychosocial interventions and resources to support patient and caregiver goals. Hospice Bereavement Program Coordinate and oversee the Hospice Bereavement Program in accordance with regulatory requirements and organizational policies. Complete or coordinate bereavement assessments and risk identification for hospice families. Develop and maintain appropriate bereavement follow-up processes based on identified needs and risk level. Provide bereavement support, counseling, referrals, and follow-up as appropriate to the individual's scope of practice. Maintain accurate and timely bereavement documentation and records. Collaborate with hospice staff and other resources to ensure continuity of bereavement support for families. Hospice Volunteer Program Oversee the Hospice Volunteer Program in accordance with organizational policies and applicable regulatory requirements. Assist with volunteer recruitment, orientation, training, scheduling, documentation, and ongoing support. Match volunteers with appropriate patient and program needs. Monitor volunteer participation and maintain required volunteer records and documentation. Provide ongoing communication, support, and recognition to hospice volunteers. Collaborate with the hospice interdisciplinary team to ensure volunteer services are appropriate to patient and family needs. Quality, Compliance & Program Development Participate in Quality Assessment and Performance Improvement (QAPI) activities related to social work, bereavement, and volunteer services. Assist with development and maintenance of social work, bereavement, and volunteer program policies, procedures, workflows, and documentation standards. Maintain current knowledge of federal and Michigan regulations affecting social work practice, HomeCare, Hospice, bereavement, and volunteer services. Identify documentation, service delivery, and program trends and communicate opportunities for improvement to leadership. Participate in surveys, audits, and regulatory activities as appropriate to the position. Professional & Organizational Responsibilities Maintain an active Michigan social work license and practice within the individual's education, licensure level, and scope of practice. Participate in required supervision and clinical oversight when required by Michigan licensure requirements or organizational policy. Participate in required meetings, in-services, continuing education, and professional development activities. Maintain patient and organizational confidentiality in accordance with HIPAA and organizational policy. Adhere to applicable professional ethical standards, including the NASW Code of Ethics. Remain flexible to changes in program needs, policies, and regulatory requirements. Perform other related duties as assigned to support HomeCare and Hospice operations.

WORK CONDITIONS

Routine in-home visits to HomeCare and Hospice patients and families within the agency's service area. Combination of in-person patient care and office-based work. Use of general office equipment, electronic health record systems, and virtual communication platforms. Frequent communication with patients, families, caregivers, healthcare providers, and interdisciplinary team members. Participation in interdisciplinary meetings, case conferences, bereavement activities, volunteer program activities, and other agency meetings as required. Attend mandatory training, meetings, or certification requirements. Travel within the agency's service area is required for patient and family visits.

QUALIFICATIONS

Bachelor's or Master's degree in Social Work from a Council on Social Work Education (CSWE) accredited social work program. LMSW preferred. Must meet Michigan requirements to use the title \"Social Worker\" and provide social work services within the individual's current level of licensure and scope of practice. Must maintain an active Michigan social work license appropriate to the individual's education and level of practice. An LLMSW or other limited-license social worker must be actively pursuing full licensure and participate in required supervision and oversight. BSW-level social workers must practice within their permitted scope and under required clinical oversight by a fully licensed LMSW when applicable. Knowledge of psychosocial assessment, counseling, care planning, community resources, and interdisciplinary healthcare practice. Home health, hospice, healthcare, or geriatric experience preferred. Proficiency with electronic health records and standard computer applications. Ability to work independently, prioritize multiple responsibilities, and communicate effectively with patients, families, caregivers, and interdisciplinary team members. Current CPR certification required (may require limited on-site attendance for certification or renewal).

REGULATORY & LICENSURE CLARIFICATION

In accordance with Michigan social work licensure and title requirements, this position must be filled by an individual who has graduated from an accredited social work program and holds an active Michigan social work license appropriate to their education and level of practice. An LMSW is preferred and may practice independently within the scope of their Michigan license. A BSW-prepared social worker or LLMSW may provide social work services within the scope permitted by Michigan law and organizational policy and will receive required clinical oversight from the agency's fully licensed LMSW. 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Find & Apply For Home Health Aide Jobs in Manistique, Michigan

Social Worker - HomeCare & Hospice