**UPMC Home Health is hiring a Social Worker-BSW for a casual position for the Tioga, Potter, and Kane Counties.** **Enjoy a Travel/ Work from Home schedule** Provide brief problem-focused assessments, psychosocial support to include end-of-life and bereavement services, and timely and appropriate discharge planning based on anticipated needs. **Responsibilities:** + Educate and advocate for patients and families to enhance their ability to make informed decisions regarding medical care, discharge planning, advance directives, and end-of-life care. + Collaborate effectively with the healthcare team, patients and families, and relevant community resources to develop and implement an individualized care plan. + Demonstrates expertise in accessing social systems by providing resource-specific information to patients and families, initiating contact with appropriate resources, and facilitating the patient/family's ability to accept referrals. + Demonstrate appropriate professional practice, maintaining respect for confidentiality and freedom of choice as outlined by the Code of Ethics by the National Association of Social Workers as well as the State Board of Social Workers, Marriage and Family Therapists, and Professional Counselors. + Demonstrate the ability to identify, assess, counsel and effectively intervene with medically and psychosocially complex patients. + Provides accurate, timely, and appropriate documentation of all social work interventions in the medical record per regulatory policies and procedures. + Demonstrate a knowledge of reimbursement systems, the ability to educate patients and families regarding payer requirements/coverage for post-acute care services, and the ability to effectively advocate on behalf of the patient. + Complete a psychosocial assessment that includes social, economic, cultural, age-related, and behavioral factors, history of child, elder, or domestic abuse, prior psychiatric or substance abuse treatment, family and social support systems, and all other available resources as appropriate to the clinical situation. + Maintain extensive knowledge of federal, state, and local assistance programs and community resources that affect patient needs. + Continue to monitor and evaluate the plan of care, options, and available services throughout the healthcare system to effectively meet the patient and family's needs. Reassess the plan of care as status changes or at a minimum of every 3 days. Bachelor of Social Work (BSW - BASW) degree required from a school accredited by the Council on Social Work Education. Minimum of one year Social Worker experience in a healthcare setting required. **Licensure, Certifications, and Clearances:** + Act 33 + Act 34 + Act 73 FBI Clearance + OAPSA **UPMC is an Equal Opportunity Employer/Disability/Veteran**