Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report.

The Social Work Care Coordinator provides coordination, education and outreach services to the Lurie Children's Health Partners Care Coordination (LCHPCC) members and their families/guardians. Primary responsibilities include assessing social service needs and identifying and addressing social barriers to members achieving optimal health care status, such as lack or inaccessibility of housing, transportation, utilities, or food. Additional responsibilities include assisting members in accessing medically necessary specialty care services and ensuring access to appropriate preventive services.

Essential Job Functions:

* Completes Health Risk and psychosocial assessments of assigned members

* Identifies care needs and goals based upon:

• Assessment findings
• Analysis of claims data
• Provider input
• LCHPCC member and parent/caregiver expressed goals
• Clinical and social data
• Review of record, participation in rounds, care conferences and clinician/family contact

*Establishes Care Plan, in conjunction with RN Care Coordinator, members, parents/caregivers and key providers. Plan shall identify:

• Essential primary, specialty, and ancillary services and providers
• Needed social support and services and identified community-based organizations that can address those needs
• Educational needs of participant and/or caregivers to enhance self-management and
• Appropriate utilization of providers to address psychological, developmental and/or medical conditions
• Potential barriers to meeting goals and plan for mitigating barriers
• Individualized disaster preparedness plan

*Assists the RN Care Coordinator in educating families on member's conditions, medical treatments and facilitates members and families becoming increasingly independent in the care of the member.

*Communication:

• Works with care team and family to implement care plan
• Provides communication link between all involved in case plan
• Assures coordination of care in collaboration with Medical team
• Collaborates regularly with payors, physicians and other agencies to improve processes and systems related to care coordination
• Assures communication with physicians, payers, business office and/or other agencies upon discharge or transfer
• Facilitates transition to next phase of care by serving as liaison between settings

* Planning:

• Convenes and facilitates Interdisciplinary Care Team (IDCT) meetings to ensure communication and coordination between CCE participant, parent/caregivers, and key healthcare and support service providers
• Refers families to resources available to meet identified needs.
• Advocates consideration of all options available to assure quality of care in the most cost-efficient manner.
• Facilitates processes to assure patients are cared for in the most appropriate setting along the Children's Hospital of Chicago Medical Center continuum
• Works closely with medical team in order to care plan goals and timeframes

* Identifies, assesses, and responds to child/family needs; includes in this process (identification, assessment, response) age-specific developmental needs, psychosocial needs, cultural needs, and spiritual needs. Particularly focuses on addressing the social and emotional needs of families that impact on a patient's medical treatment and outcome. These needs may include, but are not limited to, adjustment to illness, poor coping abilities, impairment in parental functioning, guardianship issues, adherence to treatment plan, need for additional resources due to poverty or compromised financial status, substance abuse, cultural differences, death/dying/bereavement, and family welfare (including child abuse and neglect and domestic violence)

* Monitors clinical and functional status of participants through regular face to face contact and convenes IDCT meetings on an ad hoc basis to address gaps in care or barriers to successful implementation of Care Plan

* Maintains and ensures the confidentiality of all Personal Health Information (PHI) collected and disseminated, in accordance with HIPAA requirements

* Is responsible for the assessment and management of families in emergency/crisis situations. This includes dying/death/bereavement; protective services and domestic violence issues, codes, deterioration of child's health status, or other situations deemed emergent by the family or health care team.

* Provides LCHPCC members and parents/caregivers with education required to care for child in home/community

* Directs, as appropriate, the Community Health Worker with regard to:

• Scheduling appointments
• Linking participant and family/guardian to community based organizations andservices
• Follow up with/support for participant and family/guardian
• Communication with/support for providers

*Other Responsibilities

• Adheres to all policies and procedures
• Documents in a thorough and timely manner in accordance with professional standards (see assessment/documentation policies).
• Maintains strict confidentiality of client, company and personnel information
• Demonstrates a strong commitment to the mission and values of the organization
• Continues professional growth through educational opportunities, professional literature review, or other enrichment aimed at readiness to achieve and/or maintain certification in case management as indicated.
• Completes annual training to include ADA, Cultural Competency, as well as any additional relevant trainings as assigned
• Performs other duties as assigned

Knowledge, Skills, and Abilities:

* Master's degree in social work from a university approved by the council for social work education is required.
*License in Social Work (LSW) in state of Illinois required. LCSW required with five (5) years post graduate social work experience with at least one year in a health care setting. Child welfare and mental health experience valuable.
*One to three years relevant clinical experience, current knowledge of health care trends, practices, related to pediatric health care and care coordination.
*One year of supervised clinical experience in a human-services field.
*Ability to travel locally with a valid drivers' license and automobile insurance.
*Experience working in partnership with health care professionals and support staff. Demonstrates ability to problem solve, support teamwork in a multidisciplinary setting. Must be flexible and adjust well to a changing environment.
*Computer literacy including working in Electronic Medical Record Systems, Microsoft Office applications, conducting internet research, etc.
*Excellent written and verbal communication skills necessary.
*Working knowledge of payer requirements, contracts and managed care is a plus.
*Excellent organizational and interpersonal skills
*Excellent written and verbal communication skills
*Detail oriented
*Ability to multi-task and work independently
*Excellent customer service skills
*Depending on position location, fluency in Spanish may be required.

Education

Benefit Statement

For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes:

Medical, dental and vision insurance

Employer paid group term life and disability

Employer contribution toward Health Savings Account

Flexible Spending Accounts

Paid Time Off (PTO), Paid Holidays and Paid Parental Leave

403(b) with a 5% employer match

Various voluntary benefits:

• Supplemental Life, AD&D and Disability

• Critical Illness, Accident and Hospital Indemnity coverage

• Tuition assistance

• Student loan servicing and support

• Adoption benefits

• Backup Childcare and Eldercare

• Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members

• Discount on services at Lurie Children's facilities

• Discount purchasing program

Lurie Children's and its affiliatesare equal employment opportunity employers. We value diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law.

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