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About the Role
Provide medical social work services to HIV-positive patients in the infectious disease clinic, including care coordination, benefit access, treatment adherence, education, and counseling. Serve as a member of a multidisciplinary team for a specialized HIV patient population.
Responsibilities
- Conduct initial client pre-screening to determine eligibility and appropriateness for case management.
- Complete intake, assessment, service plan development, and referrals.
- Triage emergent situations, handle phone conversations, and perform on-call duties.
- Negotiate healthcare and social service systems.
- Provide basic HIV education on disease progression, treatment, and prevention to patients and their support systems.
- Maintain accurate and timely program case records, documentation, and support reporting to DOHMH.
- Advocate for clients to obtain needed services and ensure coordination.
- Promote linkage development and monitor the effectiveness of linkages with other service providers.
- Ensure community follow-up to engage clients in care, promote compliance with medical appointments, and encourage self-sufficiency and empowerment.
- Participate in multidisciplinary case conferences and obtain case records when necessary.
- Meet monthly with clients for counseling, follow-up, and advocacy, more often as needed.
- Refer and link clients to appropriate services that promote self-sufficiency and monitor follow-through.
- Evaluate service effectiveness based on client outcomes.
- Serve as a team member on a multidisciplinary medical care team, communicating to ensure comprehensive support.
- Provide and coordinate behavioral health care management for patients in collaborative care settings.
- Conduct mental health assessments of patients in Ambulatory clinics.
- Provide psychoeducation on behavioral health treatment options.
- Consult with patients and medical providers about treatment options and preferences, coordinating treatment plan initiation.
- Provide brief, structured psychotherapy and behavioral activation for depression and anxiety.
- Maintain an electronic registry of all patients participating in the program.
- Monitor patients closely (in person or by phone) for changes using standardized measures.
- Coordinate and communicate between patient, medical provider, and consulting psychiatrist/psych NP.
- Document all encounters concisely and accurately according to organizational policies.
- Participate in QI activities as assigned and perform within acceptable limits on QA/QA indicators.
- Recommend training and maintain a tracking system for completed trainings for LMSWs and/or LMHCs, ensuring they remain up-to-date.
- Arrive punctually for work, use leave responsibly, and ensure coverage when absent.
- Comply with required standards for medical/legal reporting situations (e.g., child abuse, sexual assault).
- Serve as a Senior Clinician and Clinical Supervisor for assigned LMSWs and/or LMHCs.
- Participate in regular caseload supervision with assigned LMSWs and/or LMHCs, providing recommendations and guidance.
- Review progress notes and electronic registry entries for assigned LMSWs and/or LMHCs to provide coaching and feedback.
- Create and review data collection mechanisms to ensure program deliverables are tracked and appropriate data is collected.
- Ensure assigned LMSWs and/or LMHCs meet enrollment and service plan goals, providing support and problem-solving.
- Function as a Clinical Lead for patients experiencing crisis in Ambulatory clinics.
- Provide formal or informal teaching/consultation to health professionals and the community as requested.
- Perform other duties as assigned.
Requirements
- Knowledge of supportive housing, HIV/AIDS, and Substance abuse is required.
- Experience in assessment, service planning, and community referrals.
- Minimum formal education of Bachelor's Degree.
- Minimum of 3 years job-related experience.
- Bilingual (English/Spanish) is desired.
- Minimum 3.5 years' experience providing mental health counseling & supportive services to MSM clients & clients living with HIV or at risk of HIV is desired.
- Prior experience in brief, structured, evidence-based psychotherapy is desired.
- New York State current LCSW License.
- Ability to work with a high degree of independence in a fast-paced environment.
- Ability to work as a member of an interdisciplinary team.
- Strong written and verbal communication skills.
- Good problem-solving skills.
- Good conflict resolution skills.
- Competency in DSM 5, ICD-10, and use of CPT codes.
Skills
- Care coordination
- Benefit access
- Treatment adherence
- Basic education
- Prevention
- Counseling
- HIV education
- Behavioral health care management
- Mental health assessments
- Psychoeducation
- Psychotherapy
- Behavioral activation
- Documentation
- QI activities
- Supervision
- Data collection
- Crisis management
- Teaching
- Consultation
Location
- Wyckoff Heights Medical Center
Work Type
- Non-Union
- Days: Mon - Fri
- Shift: 9am - 5pm
Experience Level
- 3 years job-related experience
- Minimum 3.5 years' experience providing mental health counseling & supportive services to MSM clients & clients living with HIV or at risk of HIV
Education Level
- Bachelor's Degree
- LCSW License
Salary/Compensations
- $75,000
About the Company
- #WyckoffHP