Social Worker - BSW

GENERAL DESCRIPTION:

Under the supervision of the Social Work Manager, the Bachelor Social Worker (BSW) is responsible for providing outreach, social services, advocacy, and case management to participants enrolled in the program and their families. BSW will provide support with generalist Social Work areas of operation. It is the responsibility of the Social Worker to ensure that the cultural/ethical considerations of participants are addressed in long-term care programming planning and treatment.

RESPONSIBILITIES:

Case Management:

1. Provides case management services to Bienvivir participants.
2. Completes home safety screen as per fall policy if no home health services are in place.
3. Serves as a liaison with the participant’s family via home visits, family conferences, and telephone contacts, utilizing the appropriate approach to keep all parties informed.
4.  Assists Master Social Worker (MSW) as needed to complete placement cost contract and submit for approval.
5.  Completes medical alert referrals when approved by the Interdisciplinary Team (IDT).
6.  Completes disenrollment documents (death and non-death).
7.  Completes MSUR Service Delivery Day Unit form on a timely basis as needed.
8.  Assists participants with reports that are required on an annual basis (i.e., Medicaid renewals, Surveys, etc.)
9.  Refers participants and family members to community resources as needed to improve quality of life.
10.  Attends daily IDT meetings, care plan meetings, Social Work Department meetings, and CEO bi-weekly meetings via ZOOM.
11.  The Social Worker is a member of the Emergency Preparedness Team and will be available as indicated by the Emergency Plan
12.  The Social Worker will provide ongoing communication to the participant/decision-maker regarding Participant Rights, Grievance and Appeals Process, and Care Planning.

Behavioral Health:

1. Provides support to MSW assistance with completing Mini-Mental State Exam (MMSE) as scheduled.
2. Alert the MSW of any concerns voiced by visitors/participants related to Behavioral Health.

Community Liaison:

1. Establishes and maintains a positive relationship with BSHS Contracted Assisted Living/Foster Homes/ Nursing Home Facilities in order to ensure that when participants need placement or respite, their needs will be met appropriately and on a timely basis.
2. Serves as a liaison and advocate for participants and their families. With agencies such as Social Security, Health and Human Services Commission, the Housing Authority, Adult Protective Services, Probate Court, etc.
3. Assists in facilitating staff in-services by contacting outside presenters who have the expertise in providing services to the elderly.

Intake:

1. Works in conjunction with the Intake Team (Customer Service Representatives, Intake Coordinators, Intake Nurse, Intake Manager, Physician and Medicaid Eligibility workers) during the enrollment process to initiate and process both financial and medical applications for all potential participants
2. In conjunction with the Intake Team, schedules and completes the general social work assessments (MMSE and assessment), Health Care Wishes, and Enrollment Packet explanations for all applicants. Once a visitor is enrolled with Bienvivir, the Social Worker will transition each case to the Center-assigned Social
3. Reviews and completes the Enrollment Contract ‐ upon notification by the State of Texas that a Visitor has met all State requirements and is approved for Bienvivir services
4. Serves as a liaison with the Visitor, their family, and/or caregivers via home visits, family conferences, and telephone contact and communicates appropriate information as
5. May provide social services to all visitors to include community-based referrals for outreach crisis counseling and intervention and advocacy and case management
6. Provides education to Visitor and their family and/or caregivers regarding Advanced Directives, Medical Power of Attorney, and Guardianship. May initiate and complete Advanced Directives, Medical Power of Attorney, and Guardianship as needed
7. Collaborates with Enrollment Team Physician and Nurse and refers Visitors and or family/caregivers to placement options as appropriate
8. Alert MSW of any concerns voiced by visitors/participants related to Behavioral Health.

Preceptorship:

1. Familiarizes, understands, and implements the Social Services department policies and procedures.
2. Provide mentorship to Social Work Interns on Bienvivir’s mission and core values.

Professional Responsibilities:

1. Completes mandatory initial and ongoing training hours as scheduled.
2. Completes company training assignments monthly on Relias.
3. Familiarizes self with, understands and is compliant with Bienvivir policies and procedures.
4. Other duties as assigned by the Social Work Manager and/or PACE Center Director.

Required Skills

KNOWLEDGE, SKILLS, AND ABILITIES:

1.  Knowledge and experience working with the geriatric population and family systems.
2.  Knowledge of community referral system for community services.
3.  Knowledge and experience working with case management.
4.  A dependable individual with a strong knowledge base, understanding and appreciation of the elderly.
5.  Possesses the ability to communicate effectively to participants and community groups the philosophy, objective, and policies of Bienvivir Senior Health Services.
6.  Works well within the ethical principles of the Social Work Code of Ethics and exhibits appropriate behavior when related to participants and colleagues.
7.  Ability to work as a member of an interdisciplinary team and is able to communicate effectively with staff, participants, and family members.
8.  Must be bilingual (Spanish/English).
9.  Must have dependable transportation, valid driver’s license, and automobile liability insurance.
10.  Knowledge of Microsoft Office, Zoom, and Teams applications.

Required Experience

QUALIFICATIONS / REQUIREMENTS:

1. A graduate of an accredited university with a bachelor’s degree in social work or related field.
2. Preferred for BSW to become licensed by the Texas State Board of Social Worker Examiners within six months of employment.
3. One year of experience providing Social Services to a frail or elderly population preferred.