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| Employer Name: |
SpiderID: 13865900 |
| Location: Murfreesboro, Tennessee |
Date Posted: 10/18/2024 |
| Wage: |
Category: Social Services |
| Job Code: 63383 |
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| Number Of Openings: 15 |
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Job Description:
Here’s a summary of the provided job description, restructured and condensed:
### **Clinical Care Team Role Overview**
The **Clinical Care Team** focuses on supporting primary care providers by addressing patients' social determinants of health (SDOH) and conducting case management activities. The team collaborates with primary care nurses and providers to provide social services and referrals, ensuring patients receive the comprehensive support they need.
### **Key Responsibilities:**
1. **Social Support Navigation (SDOH)**
- Assist with **social needs** such as food insecurity, housing insecurity, and other SDOH challenges.
- Maintain a **resource list** with information on community services, eligibility criteria, and contact details for social services.
- Collaborate with the primary care team to provide in-person or remote social needs **screening and assessment**.
- Refer patients to appropriate **social services** (e.g., housing, food, mental health) and work closely with other social workers to coordinate services.
2. **Case Management Activities**
- Assist hospitals with **discharge planning** and follow-up.
- Help patients obtain medical records and secure necessary medical equipment through community partners.
- Conduct follow-up on care plans, ensuring patients are adhering to their health management strategies.
- Reach out to patients who are **overdue for care** or have been lost to follow-up to help them return to care.
3. **Specialty Referral Navigation**
- Schedule, track, and coordinate referrals to non-BCS specialists and imaging centers.
- Help obtain patient records from specialists and maintain a **resource list** for specialist referrals, including information on eligibility and costs.
4. **Prescription Assistance**
- Aid patients in accessing **low-cost prescriptions** through discount retailers or patient assistance programs.
- Help with applications to programs like CoverRx or RxOutreach and serve as a liaison between patients and drug companies.
5. **Community Engagement and Collaboration**
- Participate in **community meetings**, health councils, and provider meetings to build relationships with social service agencies and promote health department services.
- Identify and address barriers to care that patients may face and work on solutions to overcome these obstacles.
6. **Documentation and Reporting**
- Document interactions and services provided in the patient’s record.
- Update consults and tag providers or clinical staff as necessary.
7. **Patient Education**
- Provide education to patients or direct them to appropriate educational resources.
### **Additional Expectations:**
- Complete onboarding and orientation.
- Participate in **regional office** and **primary care clinical meetings**.
- Attend provider and community meetings as requested to build strong relationships with social services.
### **Tools and Equipment:**
- Personal Computer
- Telephone
- Fax Machine
- Printer
- Scanner
- Copy Machine
- Calculator
- Personal Vehicle (for field visits and community work)
### **Work Schedule:**
- **Days:** Monday to Friday
- **Hours:** 7.5 hours per day, with shifts starting at 8:00 AM and ending at 4:30 PM (CST)
- **Shifts:** Regular shifts, no weekends
This role requires strong collaboration skills with both the primary care team and social service providers. It also demands case management, patient education, and the ability to document and follow up on patient progress efficiently. Community engagement and resource coordination are key components of the position.
Job Requirements:
Social worker , case management experience
Job Criteria:
Start Date:
Position Type: Contractor
Years of Experience Required: 1
Education Required: Bachelors
Overnight Travel: None
Vacation Time:
Job Benefits:
Other Benefits
Company Profile:
Hanker Systems Inc. offers its clientele complete IT personnel solutions. We specialise in assisting companies set up excellent workplace solutions for their unique requirements.
Contact Information:
| Contact Name: Aishwarya S |
Company Type: Staffing Agency |
| Company: Hanker systems |
Phone: 8133365147 |
| Street: #5401, Tampa, Florida, USA |
Fax: |
| City: Tampa,FL |
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| State: Florida |
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| Zip: 33609 |
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