ED Navigator/Social Worker

•Engages in development and assessment of biopsychosocial needs assessments. Actively intervenes on provider and patient identified goals by creating care plans within the Emergency Department to be communicated to outpatient teams.
•Engages in medical case management to address social determinants of health. Serves as patient navigator within the healthcare system.
•Provides point of care brief treatment to address patient identified behavior change goals. Modalities of treatment include motivational interviewing, solution focused therapy, interpersonal therapy, and cognitive behavioral therapy.
•Supports a caseload of empaneled patients for ongoing behavioral health outreach via in-person, virtual or telephonic sessions.
•Provides crisis intervention support to address high-risk patient populations presenting to the Emergency Department or outpatient Family Medicine clinic; needs may include, acute intoxication, intimate partner violence, suicidal ideation, psychosis, etc.
•Demonstrates proficiency in data collection and analysis, particularly relating to health care utilization, social determinants of health, etc.
•Develops local resource and referral lists and procedures to be disseminated within the Emergency Department units, as well as outpatient setting.
•Provides support to Population Health Services leadership to achieve department goals and improve outcomes.