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NYC Health + Hospitals/Community Care reaches outside the walls of our hospitals and brings health care to patients where they live. With more than 600 dedicated employees, Community Care provides services including home care, community care coordination, and community-based care management to individuals managing chronic health conditions residing in Brooklyn, Manhattan, Queens and The Bronx.
At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.
9:00 A.M – 5:00 P.M
Purpose of Position:
This class of positions encompasses professional, supervisory or administrative work of varying degrees of difficulty and responsibility in the operation of a social work department providing psychosocial and other social work services to different types of patients across various settings. Ensures patient-centered quality care and services in support of better outcomes and improved patient experience, in accordance with all applicable local, state, and federal rules and regulations, and social work standards of care. All personnel perform related work.
Under direction, with wide latitude for independent judgment and decision making, performs the following:
Examples of Typical Tasks:
Performs and supervises the duties of Assignment Level I:
1. Screens charts for historical and clinical information, conducts psychosocial evaluations through interviews with patients and/or identified surrogates and formulates appropriate social work treatment plans.
2. Works within health care setting offices or in community settings within NYC to provide individual and group counseling, as well as concrete social services, as required.
3. Confers and consults with professionals in other disciplines to determine and implement a multidisciplinary approach to patient care and to develop treatment plans, evaluate patients’ progress, develop discharge and aftercare plans and recommend alternative action or treatment.
4. Provides outreach services, makes referrals to other governmental, public and/or community agencies, prepares patients to accept services, provides direct social work services on high-risk cases and may escort patients in connection with community activities and referrals, as needed.
5. As a mandated reporter, documents and reports suspected cases of child abuse or neglect to the New York State Central Registry.
6. Appears and testifies at administrative and court hearings, as necessary.
7. Assists in plans for institutional or hospital discharge and other post institutional/hospital care; evaluates alternate care arrangements for patients, where needed.
8. Participates in staff conferences and other related social work meetings, special studies, committees and/or research projects and internal/external quality assurance/performance improvement (QA/PI) activities, programs, and trainings, as required.
9. Prepares reports and related paperwork; keeps appropriate records.
10. Ensures ongoing compliance with NYC Health + Hospitals policies and procedures with national standards and other applicable external regulatory requirements, guidelines, and accreditation authorities, as well as safety and quality management standards.
11. May assist in the provision of clinical services only under supervision of a New York State LCSW, licensed psychologist, or psychiatrist.
12. Performs other related duties, as directed and with required supervision.
In addition, performs and supervises the duties of Assignment Level II:
1. Mentors and assists less experienced social work staff in social work techniques and serves as a resource in various aspects of advanced social work practice.
2. May supervise graduate and undergraduate social work students, as well as volunteers and other auxiliary personnel, as needed.
3. May assist in the provision of clinical services only under supervision of a New York State LCSW, licensed psychologist, or psychiatrist or perform such functions independently as a LCSW.
In addition, performs and supervises the duties of Assignment Level III:
1. May provide direct clinical supervision and guidance to social work staff, screen and assign cases, schedule staff, read and review staff work, evaluate work performance and/or maintain time and leave records.
2. As a Licensed Clinical Social Worker (LCSW), provides and documents clinical supervision of NYC H+H Licensed Master Social Workers (LMSWs) toward advanced Social Work licensure in alignment with all the relevant professional standards and practices, and in accordance with all applicable NYS licensure laws.
3. Maintains individualized supervision logs documenting clinical supervision and ensures timely completion of attestation forms required by NYSED Office of the Professions to support LCSW licensure applications, as applicable.
4. May conduct or lead special studies and projects including the collection and evaluation of data related to vulnerable patient populations and prepare and present reports related to these service populations.
5. Establishes and maintains professional social work standards of performance concerning interview techniques and methods and practices used in preparing clinical assessments, developing treatment plans, and in documenting case histories
6. Interprets clinical information based on case data, histories, statistics, etc.; prepares and submits comprehensive reports of case findings including chronologies of medical data and social factors necessary to support recommended courses of action.
7. Orients and educates members of other professional disciplines by developing training curricula and presenting on social work concepts and functions.
8. Trains and instructs staff in agency policies and procedures and in appropriate social work techniques, methods and practices.
9. Ensures compliance with accepted social work practices and principles and operational adherence to government rules and regulations, including compliance with reporting requirements.
10. Participates in conferences, committees and meetings on- and off-site with supervisory/managerial staff, other clinical professionals and with representatives of government and other agencies and/or community organizations.
11. Analyzes population health issues relevant to the area of responsibility and serves as a liaison to community agencies and/or groups.
12. Liaises with community agencies, facilitating communication between the agencies and the department/health care setting and the utilization of available community resources.
13. In the temporary absence of the supervisor, may perform the duties of that position.
In addition to performing and supervising the duties of Assignment Levels I, II and III, as described above, performs the following typical tasks:
1. Provides clinical supervision, assigns work to and provides professional expertise and supervision to a number of social work units on complex cases. Establishes supervisory controls and ensures the work performed meets the agency’s standards and time frames.
2. Coordinates the work of staff with that of other government and non-governmental agencies providing information and direction, facilitating effective working relationships and promoting cooperation to enhance the achievement of mutual work objectives and the patient experience.
3. Plans, develops, implements and coordinates programs and activities to attain stated objectives and to meet identified needs.
4. Provides consultation and technical assistance to subordinate staff and others by researching and analyzing information and recommending corrective actions to be taken.
5. Assesses staff training needs, develops and revises lesson plans to meet training requirements and conducts training sessions, workshops or conferences, as needed.
6. Interprets and communicates procedures, regulations and program directives.
7. Responds to mail, telephone, and in person inquiries; obtains needed information to assist patients, agencies, courts and others; attends interdisciplinary meetings and conferences as needed.
8. May participate in drafting policy and procedural manuals, memos or other instructional guides for Central Office approval.
1. Valid license as an LCSW issued by the NYSED and one (1) year of supervisory experience utilizing casework, group work and/or community organization methodologies.
1) Consents patients into appropriate care management program (e.g., Health Home, Non-Medicaid, etc.); utilize motivational interviewing to complete intake or yearly assessment; and develop longitudinal care plan with an emphasis on increasing self management and harm reduction.
2) Completes all specialized patient evaluations (e.g., Health and Recovery Plan) and documentation in specific systems (e.g., CARES, UAS-NY).
3) Works in the community to connects patients to a variety of clinical and support services including but not limited to behavioral health, medical services, pharmacy, social, legal, public assistance, transportation, housing services, etc.
4) Provides care management services in hospitals, health centers, and various community-based settings. Provides a minimum of two core services (or three documented attempts) per month with a minimum of one face-to-face (FTF) engagement quarterly, for each assigned patient. Adheres to intensified monthly core services and face-to-face engagement thresholds established for each sub-program (e.g., Health Home Plus (4 core services / 2 FTF), AOT (4 core services / 4 FTF), NYC Department of Health & Mental Hygiene (DoHMH) Grant (2 core services / 2 FTF).
5) Convenes case conferences (every six months at minimum), ensuring each patient's care team is up-to-date on patient's status and needs. Responds promptly to all care team member inquiries and ensure that all discussions are documented in the electronic medical record (EMR). Prioritizes case conferences for any patient exhibiting signs and symptoms of behavioral health crisis or relapse to use of substances or alcohol.
6) Maintains expertise in approved techniques for deescalation, crisis management, and safety planning to effectively monitor and support patients in managing triggers, coping with stressors, and seeking crisis support. Proactively develops safety plans for all enrolled patients, and updates them at least annually.
7) Monitors and responds to critical alerts (e.g., inpatient hospital and emergency department admission / discharge, arrest/incarceration, etc.) in accordance with all related policies for supporting transitions of care.
8) Utilizes a directory of service providers to support connection of patients to medical, behavioral health, social support, wellness and family support services, in support of meeting care plan goals and interventions.
9) Develops and maintains proficiency in the EMR. Proactively manages daily schedule to balance travel time, appointment duration, and ensure documentation of all work completed daily.
10) Demonstrates integrity, compassion, accountability, respect and excellence in all interactions with leaders, colleagues, patients and community stakeholders.
11) Adheres to all operating policies, procedures and requirements as defined and subject to change by all applicable federal, state, local, and corporate requirements.
12) Performs other duties as assigned.
13) Mental health, substance use/recovery, crisis intervention, case management/care management, de-escalation, motivational interviewing, cognitive behavioral therapy.
14) Preferred: New York State CASAC (Credentialed Alcoholism & Substance Abuse Counselor.
NYC Health and Hospitals offers a competitive benefits package that includes:
If you wish to apply for this position, please apply online by clicking the "Apply for Job" button Job ID # 133757.
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