other
Posted 1 weeks agoSocial Worker – Dementia Navigation Services (BSW)
Roanoke, United StatesOn-site
Responsibilities
- Develop and implement individualized service plans in collaboration with clients, families, and interdisciplinary teams.
- Advocate for client rights, dignity, and person-centered care approaches.
- Coordinate with community partners to ensure continuity of care.
- Document all client interactions, care plans, and service outcomes in accordance with organizational and regulatory standards.
- Identify and address safety concerns, including risks related to wandering, medication, adherence, or neglect.
- Support outreach efforts and community education related to dementia services.
Requirements
- Resource Navigation Maintain knowledge of local, state, and federal programs (e.g., Medicaid waivers, aging services, transportation, housing supports).
- experience to plan and coordinate patient care.
- Maintains an extensive knowledge of benefit plans, regulatory guidelines and resources and serves as a resource to maximize utilization and cost effectiveness.
- Provides education and self-management strategies to patients and families around issues related to adaptation of the patient’s health and addressing any contributing barriers to achieving goals. What We Require: Education: Bachelor's degree in social work required.
- experience in health care setting preferred.
Benefits
- Employment Status: Full time Shift: Day (United States of America) Facility: 1615 Franklin Rd - Roanoke Requisition Number: R160386 Social Worker – Dementia Navigation Services (BSW) (Open) How You’ll Help Transform Healthcare: In collaboration with the health care team, the social worker assists patients and families with personal and environmental difficulties with predisposed illness or interferes with obtaining maximum benefits from medical care.
- Services include providing patient and families with the psychosocial support needed to cope with disease and life limiting illness, advising family and caregivers, providing education and support, and making referrals for other services as needed or requested. Social Worker – Dementia Navigation Services (BSW) within Homecare Services.
- This will be a grant funded position for the Navigation program, starting out as a 1-year position conditional upon grant funded agreement being extended. Company equipment.
- Position Summary The Social Worker (BSW) provides care navigation, resource coordination, and supportive services to individuals living with dementia and their caregivers.
- Connect clients to appropriate medical, behavioral health, social, and community-based services (e.g., home health, adult day services, and respite care).
- Assist with transitions of care, including hospital discharge, long-term care placement, or in-home support expansion as needed.
- Coordinates the transition plan with the care team and recommends further treatment for the patient to achieve optimal level of healthy lifestyle, behaviors, and functioning.
- Arranges and coordinates assistance/referrals for unmet patient/family needs, to include social service, financial, and insurance applications and follow up, medications, DME, and transportation to/from clinic appointments.
- Remains current with social work and health care developments and seek to increase further enhancement of job-related knowledge.
- Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status.
- benefits package, and many perks and well-being resources to help you live a happy, healthy life – at work and when you’re away.
- benefits available to you when you join Carilion: Comprehensive Medical, Dental, & Vision
- Benefits Employer Funded Pension Plan, vested after five years (Voluntary 403B) Paid Time Off (accrued from day one) Onsite fitness studios and discounts to our Carilion Wellness centers Access to our health and wellness app, Personify Health Discounts on childcare Continued education and training
Contact
- Ability and willingness to work as an integral member of a multi skilled team Recruiter: Chris Fitzgerald Recruiter Email: cdfitzgerald@carilionclinic.org For more information, contact the HR Service Center at 1-800-599-2537.
- For more information on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies Benefits, Pay and Well-being at Carilion Clinic Carilion understands the importance of prioritizing your well-being to help you develop and thrive.
Additional details
- This role focuses on guiding clients through healthcare, community resources, and long-term support systems while promoting quality of life, safety, and independence. Key
- Client & Caregiver Support Provide education on dementia progression, caregiving strategies, and available resources.
- Offer emotional support and guidance to caregivers, addressing stress, burnout, and coping strategies.
- Assist clients with applications, referrals, and eligibility processes.
- Monitoring & Follow-Up Monitor client progress and reassess needs monthly.
- Collaboration Work closely with healthcare providers, case managers, and community organizations.
- Participate in interdisciplinary team meetings and case reviews.
- Provides psychosocial assessments of patients and families to identify emotional, social, and environmental strengths and problems related to their preventative health management, diagnosis, illness, treatment, and/or life situation.
- Evaluates the plan at appropriate intervals and modifies the plan as necessary.
- Monitors, evaluates, and records client progress according to measurable goals described in treatment and care plan.