<p>Navajo Preference Employment Act In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference. Overview POSITION SUMMARY Incumbent serves as an Outpatient/Inpatient Social Worker for TCRHCC and/or Sacred Peaks Healthcare Center (SPHC) and is responsible for direct supervision and supportive contact for the specific group of identified high risk patients. The Social Worker is responsible for designing and managing a continuum of care focusing on empowering clients to achieve demonstrable outcomes and self-sufficiency. The Social Worker is responsible for assessment, service planning, and resource acquisition, monitoring progress and initiating and responding to emerging client needs. The Social Worker will link the client with Community Social Service providers, health care providers, substance abuse, and mental health providers to achieve specific goals. A Social Worker job involves assessing client needs, developing and implementing care plans, coordinating services, advocating for clients, and monitoring progress to ensure clients receive the necessary support and resources. The Social Worker is responsible for utilizing the review of patient cases in the inpatient and outpatient services departments, and review of medical necessity of referrals to specialty providers for services not normally provided within the TCRHCC facility. The incumbent will work with a multidisciplinary team to promote the efficient and effective use of a variety of health care resources by focusing on the whole patient to provide a seamless continuum of care. The goals are the provision of quality care, decrease the fragmentation of care, enhancement of patient self-care and quality of life, and cost containment. The incumbent will work closely with Providers, Nurses, and Case Managers, Physicians, the PRC department, and all health care providers staff at TCRHCC to ensure implementation of appropriate resources in the fulfillment of utilization goals for the hospital and third-party payors. The Social Worker will be responsible to the Director of Case Management/Care Coordination. Collaborates with an interdisciplinary team to assess care plans, monitor progress, and make recommendations to ensure safe and efficient hospitalizations. Responsible for evaluating patients in the ED for medical necessity and care coordination needs. Assesses potential admissions and works with advanced practice clinicians/physicians to determine appropriate admission status. Proposes and implements outpatient plans for safe discharge from the ED with physician approval. Coordinates care for patients with abuse, chronic pain, and frequent utilization issues. Interacts with patients or customers of all ages, from newborn to geriatric. As part of this role, they will also interact with individuals who have mental health issues to help them access and navigate the resources they need to improve their well-being. with individuals who have mental health issues to help them access and navigate the resources they need to improve their well-being Qualifications NECESSARY QUALIFICATIONS Education: • Master's degree in social work (MSW) License/Certification: • Licensed Master Social Worker (LMSW) or Licensed Clinical Social Worker (LCSW). A valid, current, full and unrestricted Professional License to practice LMSW or LCSW in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States. • Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association throughout employment. Experience: • Must have a minimum of three (3) years' experience in the clinical care setting • Experience and knowledge of discharge planning, case management, or utilization review processes. • Demonstrate knowledge of electronic health record systems. Other Skills and Abilities: A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas: • Positive working relationships with others • Possession of high ethical standards and no history of complaints • Reliable and dependable; reports to work as scheduled without excessive absences • Effective verbal & written communication skills • Team management focuses on promoting a positive and proactive approach to problem resolution. • Completion of satisfactory and above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job. • Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job. • Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job • Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC. MENTAL AND PHYSICAL EFFORT The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be provided to enable individuals with disabilities perform the essential functions. Physical: This position requires an individual with high energy who can maintain a long and flexible schedule to meet the management requirements. The physical requirements include sitting at a desk for long periods of time, long periods of sitting in meetings; frequent sitting for intense work on a personal computer, frequent walking to interact with staff within the facility, frequent bending, kneeling, crouching, twisting, maintaining balance and reaching. Must be able to hear, speak and comprehend over the telephone and in person with others. Must have the ability to lift, push and pull up to 50lbs frequently. Sensory requiremen1s for position include prolonged ability for far, near, and color vision, depth perception, seeing fine details, hearing normal speech, telephone use and ability to frequently hear overhead pages. Must have ability of both hand manipulation in simple and firm grasping, fine manipulation, and use of keyboard. Mental: Uses independent judgment and analytical skills to make decisions that impact operations, finances, and customer service within the organization. The incumbent must have the ability to perform in structured and unstructured environments and possess a keen attention to detail and propose practices/mechanisms to enhance customer satisfaction. Must have ability to continually concentrate, handle a high degree of flexibility, handle multiple priorities in stressful situation, demonstrate high degree of patience, adapt to shift work, work in areas that are close in crowded, frequently cope with high levels of stress, make decisions under high pressure, work alone, and occasionally cope with anger/fear/hostility of others in a calm way and manage altercations. Environmental: May frequently be exposed to chemical agents, extremes in temperature of humidity, occasional exposure to infectious diseases, dust, fumes, gases, hazardous or moving equipment, and loud noises. Responsibilities ESSENTIAL FUNCTIONS 1. Coordination of service specific assessments, service planning and enrollment 2. Works with all facets of the Case Management continuum (i.e., social support, alternate resources, community referrals, discharge planning, Nursing Home/Skilled Nursing Placement and resource utilization). 3. Comprehensive and client centered service planning and coordination 4. Works proactively with the established RN Case Managers and Social Workers of TCRHCC as a team member for care coordination of the patient populations served by TCRHCC 5. Resource acquisition facilitated referrals and linkages. 6. Consistent and on-going case consultation with all direct service providers 7. Developing and maintaining internal and external resource relationships 8. Service monitoring and following up to ensure continuity of care and updating the client service plan 9. Identifies patient through consultation and high-risk diagnoses (i.e., COPD, CHF, OM) 10. Perform UR coordination functions by ensuring medical necessity of preadmission, admission, continued stay, cost containment and discharge planning on patients admitted TCRHCC. 11. Accountable for the education, knowledge and process related to the Recovery Audit Contractors role in inpatient and outpatient reimbursement as related to the impact on TCRHCC revenue. 12. Reviews TCRHCC inpatient admissions for medical necessity and is the lead for UR Committee reviews in collaboration with the Medical Staff representative. 13. Assists with the development of department reports, policy/procedures manuals, and program objectives 14. Assists with special projects as assigned 15. Conducts system and procedural efficiency evaluation to determine progress, performance, and conformity with program requirements 16. Assist in managing outpatient referrals for Purchased Referred Care (PRC) 17. Follow up outside inpatient referrals for continued follow up (i.e., appointments and PHN referrals) 18. Will provide coverage for the inpatient units-ACU, PEDS, ICU, OB, and ER to include Outpatient Clinics. Manages care of prioritized TCRHCC/SPHC outpatient/inpatient based upon consultation from providers within the TCRHCC/SPHC healthcare delivery system; provides a consistent and on-going consultation with service providers. 19. Works proactively and collaboratively with Public Health Nursing (PHN), Patient Benefit Coordinators (PBC), Utilization Review (UR) and Purchased Referred Care (PRC) at TCRHCC/SPHC. 20. Facilitate communication and coordination between members of the health care team, involving the client in the decision making process to minimize fragmentation in the services (CMSA, 2010). 21. Develops with the patient/family and multidisciplinary team (including service area and/or other non-TCRHCC/SPHC providers as appropriate) a care and service delivery plan based upon the needs identified and available provider and financial resources of the patient and provide consistent and on-going case consultation with all direct service providers. 22. Provides service monitors and follow-up to ensure continuity of care, and updates of the client service plan and provides follow-up if needed. Striving to promote client self-advocacy and self-determination (CMSA, 2010). 23. Prepares patient and family for discharge from case management when services are no longer required. Arranges for any ongoing support/direct care services that the patient will need post-discharge in coordination with discharge planners and other entities such as PHN, Comm unity Health Representatives or Tribal Social Services. 24. Will be familiar with Advance Directives and be a resource person for patients and families; facilitate informed choice, consent and decision-making. 25. Promote use of evidence-based care, as available, in conjunction with the MCG Care Guidelines. 26. Pursue professional excellence and maintain competence in practice. 27. Serves as the outpatient/inpatient coordinator, such as: • The primary contact for outpatient/inpatient in obtaining beds for admissions both within and outside of TCRHCC/SPHC. • Collaborate with provider and nursing personnel to ensure admissions are conducted seamlessly and without delay of patient care. • Collaborates with provider, nursing personnel and patient benefits coordinators that all admission documentation is complete and all referrals for third party resources are complete prior to the departure of patients. 28. Will be committed to Case Management Services and have some assignments with Purchased and Referred Care (PRC) formally known as Contract Health Services, and aiding the PRC Case Specialist 29. Will share in coverage all units, inpatient and outpatient for staffing shortages. 30. Incumbent will be required to take call on scheduled weekends as deemed necessary 31. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. 32. Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for the most current process) 33. Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction. 34. Performs other duties as assigned.</p>